The Annals of pharmacotherapy · 1992
Enhanced anticoagulant effect of coumarin derivatives induced by doxycycline coadministration.
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Caraco Y, Rubinow A
Аннотация
OBJECTIVE: To report two cases of enhanced oral anticoagulant effect induced by doxycycline coadministration.
DESIGN: Case report.
SETTING: University teaching hospital.
PATIENTS: Two patients on chronic oral anticoagulation therapy who presented with severe bleeding and marked impairment in blood coagulation tests shortly after the initiation of doxycycline therapy.
DISCUSSION: The literature concerning the possible effects of tetracyclines on hemostasis with or without antecedent anticoagulation therapy is reviewed and the speculated mechanisms for such an interaction are discussed.
CONCLUSIONS: The administration of tetracyclines such as doxycycline to patients on chronic oral anticoagulation therapy may be associated with a marked enhancement in anticoagulant effect. In such patients the prothrombin ratio should be closely monitored and the anticoagulant dosage adjusted accordingly.
DESIGN: Case report.
SETTING: University teaching hospital.
PATIENTS: Two patients on chronic oral anticoagulation therapy who presented with severe bleeding and marked impairment in blood coagulation tests shortly after the initiation of doxycycline therapy.
DISCUSSION: The literature concerning the possible effects of tetracyclines on hemostasis with or without antecedent anticoagulation therapy is reviewed and the speculated mechanisms for such an interaction are discussed.
CONCLUSIONS: The administration of tetracyclines such as doxycycline to patients on chronic oral anticoagulation therapy may be associated with a marked enhancement in anticoagulant effect. In such patients the prothrombin ratio should be closely monitored and the anticoagulant dosage adjusted accordingly.