The effect of carbamazepine on warfarin anticoagulation: a register-based nationwide cohort study involving the Swedish population

Journal of Thrombosis and Haemostasis : JTH
B MannheimerJ D Lindh

Abstract

There are data indicating that the interaction between warfarin and carbamazepine results in decreased warfarin efficacy. However, the evidence on the magnitude of and interindividual differences in susceptibility to this interaction has remained scarce. To investigate the effect of carbamazepine on warfarin anticoagulation and warfarin maintenance doses by the use of data from three nationwide registries. In a retrospective cohort study including 166 patients, warfarin doses were compared 2-4 weeks before and 10-13 weeks after initiation of cotreatment with carbamazepine. In addition, warfarin doses and International Normalized Ratio (INR) values were calculated week-by-week during cotreatment. Data on prescribed warfarin doses and INR measurements were obtained from two large Swedish warfarin registers. Data on carbamazepine use were retrieved from the Swedish Prescribed Drug Register. The average warfarin doses were 49% (95% confidence interval 43-56) higher during carbamazepine treatment. The INR decreased upon carbamazepine initiation, and subtherapeutic INR levels were observed in 79% of all patients during the fifth week of cotreatment. Warfarin maintenance dose increases exceeding 50% and 100% were observed in 59% and 1...Continue Reading

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Citations

Jan 26, 2017·Clinical and Applied Thrombosis/hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis·Nathan P ClarkDaniel M Witt
Aug 5, 2017·Scandinavian Journal of Primary Health Care·Reyes Serrano TeruelAnn Helen Kristoffersen
Apr 11, 2020·Clinical Pharmacology and Therapeutics·Meijia ZhouSean Hennessy
Jun 16, 2019·European Journal of Clinical Pharmacology·Marine L AnderssonJonatan D Lindh
Feb 22, 2017·Neurologia i neurochirurgia polska·Claudia Stöllberger, Josef Finsterer
Jan 26, 2021·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Narong PuttasungNijole Bernaitis
Dec 19, 2020·Seizure : the Journal of the British Epilepsy Association·Roy G Beran

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