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2014 | 9 | 2 | 231-234
Tytuł artykułu

Interaction between Levothyroxine and Phenprocoumon: a case report

Treść / Zawartość
Warianty tytułu
Języki publikacji
EN
Abstrakty
EN
Several case reports have associated the combined use of thyroid drugs and oral anticoagulants, like coumarin, with overanticoagulation. However, this effect has never been described for phenprocoumon, a coumarin derivate that is widely prescribed in continental European countries and in Latin America. We describe a 62-year-old female who had an unexpectedly labile anticoagulation profile when levothyroxine (Puran T4®) was added to her drug therapy regimen, which included phenprocoumon (Marcoumar®). This resulted in an elevated international normalized ratio (INR) that was unrecordable and bleeding (macroscopic hematuria) that required hospitalization and treatment with vitamin K. The patient had been taking phenprocoumon for almost ten years for systemic embolism prophylaxis because of her history of mechanical bileaflet mitral valve prosthesis. One month before the events described, the patient was prescribed sodium levothyroxine (50 mcg daily) to treat hypothyroidism (TSH = 40 µU/mL; reference range, 0.40–4.0 µU/mL). Approximately 3 weeks prior to initiation of levothyroxine treatment, her INR was 2.8. A drug interaction was therefore suspected. The Horn Drug Interaction Probability Scale (DIPS) indicated a probable interaction between oral phenprocoumon and levothyroxine in this case. Clinicians should be aware that levothyroxine may interact with oral phenprocoumon, resulting in overanticoagulation.
Wydawca

Czasopismo
Rocznik
Tom
9
Numer
2
Strony
231-234
Opis fizyczny
Daty
wydano
2014-04-01
online
2014-02-13
Twórcy
  • Department of Pharmacology and Therapeutics, State University of Maringa, Avenue Colombo 5790, 87020-290, Maringá, PR, Brazil
  • Department of Pharmacology and Therapeutics, State University of Maringa, Avenue Colombo 5790, 87020-290, Maringá, PR, Brazil, paulorobreli@yahoo.com.br
  • Department of Pharmacology and Therapeutics, State University of Maringa, Avenue Colombo 5790, 87020-290, Maringá, PR, Brazil
Bibliografia
  • [1] Gadisseur AP, van der Meer FJ, Adriaansen HJ, Fihn SD, Rosendaal FR. Therapeutic quality control of oral anticoagulant therapy comparing the short-acting acenocoumarol and the long-acting phenprocoumon. Br J Haematol 2002;117:940–946 http://dx.doi.org/10.1046/j.1365-2141.2002.03493.x[Crossref]
  • [2] Ansell J, Hirsh J, Hylek E, Jacobson A, Crowther M, Palareti G, et al. Pharmacology and management of the vitamin K antagonists: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest 2008;133:160S–198S http://dx.doi.org/10.1378/chest.08-0670[Crossref]
  • [3] Beinema M, Brouwers JR, Schalekamp T, Wilffert B. Pharmacogenetic differences between warfarin, acenocoumarol and phenprocoumon. Thromb Haemost 2008;100:1052–1057 [WoS]
  • [4] Cadamuro J, Dieplinger B, Felder T, Kedenko I, Mueller T, Haltmayer M, et al. Genetic determinants of acenocoumarol and phenprocoumon maintenance dose requirements. Eur J Clin Pharmacol 2010;66:253–260 http://dx.doi.org/10.1007/s00228-009-0768-7[WoS][Crossref]
  • [5] Leiria TL, Pellanda L, Miglioranza MH, Sant’anna RT, Becker LS, Magalhães E, et al. Warfarin and phenprocoumon: experience of an outpatient anticoagulation clinic. Arq Bras Cardiol 2010;94:41–45 http://dx.doi.org/10.1590/S0066-782X2010000100008[WoS][Crossref]
  • [6] Hirsh J, Dalen J, Anderson DR, Poller L, Bussey H, Ansell J, et al. Oral anticoagulants: mechanism of action, clinical effectiveness, and optimal therapeutic range. Chest 2001;119:8S–21S http://dx.doi.org/10.1378/chest.119.1_suppl.8S[Crossref]
  • [7] Ufer M, Svensson JO, Krausz KW, Gelboin HV, Rane A, Tybring G. Identification of cytochromes P450 2C9 and 3A4 as the major catalysts of phenprocoumon hydroxylation in vitro. Eur J Clin Pharmacol 2004;60:173–182 http://dx.doi.org/10.1007/s00228-004-0740-5[Crossref]
  • [8] Ufer M. Comparative pharmacokinetics of vitamin K antagonists: warfarin, phenprocoumon and acenocoumarol. Clin Pharmacokinet 2005;44:1227–1246 http://dx.doi.org/10.2165/00003088-200544120-00003[Crossref]
  • [9] Gavronski M, Hartikainen S, Zharkivsky A. Analysis of potential interactions between warfarin and prescriptions in Estonian outpatients aged 50 years or more. Pharmacy Practice 2012;10:9–16 [PubMed]
  • [10] Brunton L, Parker K, Blumenthal D, Buxton I. Goodman & Gilman. Manual of Pharmacology and Therapeutics. New York: The McGraw-Hill Companies, 2008
  • [11] British Medical Association and the Royal Pharmaceutical Society of Great Britain. British National Formulary. London: BMJ Publishing Group, 2009
  • [12] Drugs.com. Drug interactions between coumadin and levothyroxine from Drugs.com. Available from: http://www.drugs.com/drug-interactions/coumadin-with-levothyroxine-2311-1529-1463-0.html. Accessed: 2011 October
  • [13] Horn JR, Hansten PD, Chan LN. Proposal for a new tool to evaluate drug interaction cases. Ann Pharmacother 2007;41:674–680 http://dx.doi.org/10.1345/aph.1H423[Crossref][WoS]
  • [14] Freedman MD, Olatidoye AG. Clinically significant drug interactions with the oral anticoagulants. Drug Saf 1994;10:381–394 http://dx.doi.org/10.2165/00002018-199410050-00003[Crossref]
  • [15] Owens JC, Neely WB, Owen WR. Effect of sodium dextrothyroxine in patients receiving anticoagulants. N Engl J Med. 1962;266:76–79 http://dx.doi.org/10.1056/NEJM196201112660205[Crossref]
  • [16] Bubber P, Bubber N, Bansal DD. Effect of thyroxine on plasminogen activator and inhibitor activity in rat. Indian J Exp Biol 2009;47:147–150
  • [17] Negrev N, Tashev R, Radev R, Anogeianaki A, Ivanova M. Hormones of hypothalamic-pituitarythyroid axis are significant regulators of synthesis and secretion of vitamin K-dependent plasma coagulation factors. J Biol Regul Homeost Agents 2011;25:21–26
  • [18] Walters MB. The relationship between thyroid function and anticoagulant therapy. Am J Cardiol 1963;11:112–114 http://dx.doi.org/10.1016/0002-9149(63)90043-2[Crossref]
  • [19] Food and Drug Administration. Unithroid (levothyroxine sodium tablets, USP). Available from: http://www.accessdata.fda.gov/drugsatfda_docs/label/2000/21210lbl.pdf. Accessed: 2011 October
  • [20] Harder S, Thürmann P. Clinically important drug interactions with anticoagulants. An update. Clin Pharmacokinet 1996;30:416–444 http://dx.doi.org/10.2165/00003088-199630060-00002[Crossref]
Typ dokumentu
Bibliografia
Identyfikatory
Identyfikator YADDA
bwmeta1.element.-psjd-doi-10_2478_s11536-013-0260-8
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