Inhibition of phenprocoumon anticoagulation by carbamazepine. |
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Authors: | R Schlienger M Kurmann J Drewe F Müller-Spahn E Seifritz |
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Affiliation: | Division of Clinical Pharmacology, Department of Internal Medicine, University Hospital, Basel, Switzerland. |
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Abstract: | Carbamazepine inhibits warfarin and dicoumarol anticoagulation through induction of cytochrome P450-enzymes. Inhibition of phenprocoumon anticoagulation by carbamazepine has been supposed in some reviews, however, without hard empirical evidence. We report a patient who was anticoagulated with phenprocoumon in whom carbamazepine produced a dramatic increase in prothrombin time ratio (Quick). After discontinuation of carbamazepine, Quick-values returned to therapeutic levels. Valproate did not affect phenprocoumol's anticoagulant properties. The potentially hazardous carbamazepine-phenprocoumon interaction should be emphasized in reference drug manuals. |
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