| Autor: |
André Wieringa, Helle-Brit Fiebrich, Fleur van Gelder, Abraham J. Valkenburg, Jan Gerard Maring, Elise J. Smolders |
| Rok vydání: |
2023 |
| Předmět: |
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| Zdroj: |
Current Drug Safety. 18 |
| ISSN: |
1574-8863 |
| DOI: |
10.2174/1574886318666230310104322 |
| Popis: |
Background: Phenprocoumon is a vitamin K antagonist that is widely prescribed in Europe and Latin America for the prophylaxis and treatment of thromboembolic events Case presentation: A 90-year-old female was admitted to our hospital with tonic-clonic seizures, possibly due to dementia syndrome. Discussion: Valproic acid (VPA) was prescribed for the treatment of seizures. VPA is an inhibitor of cytochrome P450 (CYP) 2C9 enzymes. A pharmacokinetic interaction with phenprocoumon occurred, which is a substrate for CYP2C9 enzymes. The interaction resulted in a strong INR increase and subsequent clinically relevant bleeding in our patient. Valproic acid is not specifically mentioned in the phenprocoumon drug label as a CYP2C9 inhibitor, and in the Dutch medication surveillance database, no medication alert is shown when prescribing this combination, and no interaction with phenprocoumon has been reported so far. Conclusion: When prescribing this combination, the prescriber should be warned and advised to intensify INR monitoring if the combination is to be continued. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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