PMID: 16502767Mar 1, 2006Paper

Drug interaction between capecitabine and warfarin: a case report and review of the literature

International Journal of Clinical Pharmacology and Therapeutics
Y YildirimB Basturk

Abstract

To report on possible adverse interaction between capecitabine and warfarin in a patient with cancer, who developed subconjunctival and nose bleeding during treatment with these drugs and review of the previously reported five cases in the literature. In the second week of capecitabine treatment the patient was hospitalized owing to subconjunctival hemorrhage and nose bleeding. Her international normalized ratio (INR) level was found to have increased, and both drugs were discontinued. Fresh frozen plasma replacement was administered. Warfarin and capecitabine treatment were restarted again but the warfarin dose was decreased. The patients INR was kept between 2.5-3 with the reduced dose of warfarin. Capecitabine is an orally active prodrug of fluorouracil (FU) and is extensively used as an antineoplastic agent. It is converted to 5-FU in the liver and tumor tissues. Warfarin is an antithrombolytic agent and is metabolized by liver cytochorom P450 (CYP) isoenzymes in liver. Preclinical in vitro studies using human liver microsomes report no inhibitory effects between capecitabine and substrates of CYP. However, the concomitant administration of capecitabine and warfarin resulted in gastrointestinal, retroperitoneal bleeding and...Continue Reading

Citations

Jan 29, 2010·Cancer Chemotherapy and Pharmacology·Masaru NakajimaYasufumi Sawada
Nov 1, 2011·Clinical Therapeutics·Denys T LauJune M McKoy
Dec 7, 2010·Pharmacotherapy·Sachin R ShahSarah M Gressett Ussery
Mar 20, 2019·European Archives of Oto-rhino-laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery·Eline MarinThibaut Van Zele
Jun 25, 2016·Cancer Chemotherapy and Pharmacology·Tsuyoshi HataTaroh Satoh

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