Interaction between warfarin and the herbal product Shengmai-yin: a case report of intracerebral hematoma.

Yonsei Medical Journal
Qun Su, Yuhong Li

Abstract

A 71-year-old man was stable on warfarin (2.25 mg daily) therapy with an international normalized ratio (INR) of 1.8-2.2 after a heart valve replacement surgery. Recently, he consumed the liquid-like herbal product called shengmai-yin (10 mL daily) against medical advice. Seven days after the daily consumption of shengmai-yin, he was admitted to the intensive care unit because of consciousness disturbance [Glasgow Coma Scale (GCS) score 7] with an INR of 5.08. Head computed topography revealed intracerebral hematoma in the left temporoparietal region. Both warfarin therapy and the herbal product were withdrawn. At the same time, therapy with intravenous vitamin K1 40 mg was started. On the second day of admission, craniectomy was performed to remove the intacerebral hematoma under general anesthesia. He remained confused and restless for 2 days, but then showed progressive recovery in the consciousness level as well as motor and verbal functions. Shengmai-yin contains herbal ingredients that can interact with warfarin. The Drug Interaction Probability Scale (DIPS) indicated that warfarin and shengmai-yin were highly probable causes of intracerebral hematoma. Patients on warfarin therapy should be discouraged from taking herbal ...Continue Reading

References

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Citations

Dec 23, 2014·Evidence-based Complementary and Alternative Medicine : ECAM·Li-Peng JiangZhong-Ze Fang
Aug 12, 2014·BioMed Research International·Tung-Ting ShamShun-Wan Chan
Jan 25, 2018·British Journal of Clinical Pharmacology·Charles AwortweBernd Rosenkranz
Aug 28, 2019·Current Drug Metabolism·Jiajia LiGuangChun Sun
Jun 2, 2020·British Journal of Clinical Pharmacology·Christina San San Tan, Shaun Wen Huey Lee
Aug 27, 2021·Medicines·Mary Beth BabosPaul Herscu

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