title: Effect of tienilic acid (Diflurex) on the binding of warfarin 14C to human plasma proteins.
abstract: Tienilic acid (Diflurex), a new diuretic with a chemical structure close to that of ethacrynic acid, displaces significant amounts of warfarin from 2 g/l human albumin in vitro by a competitive mechanism. When physiologic concentrations of human albumin are used, or with human plasma there is no such interaction. Because excessive hypoprothrombinaemia and haemorrhage were reported in vivo when tienilic acid was added to oral coumarin anticoagulant therapy, it is advised to use another diuretic if necessary.
mesh_terms: D000368:Aged; D001667:Binding, Competitive; D001798:Blood Proteins / Q000378:metabolism; D003956:Dialysis; D006016:Glycolates / Q000494:pharmacology*; D006801:Humans; D007700:Kinetics; D008297:Male; D011485:Protein Binding / Q000187:drug effects; D013989:Ticrynafen / Q000494:pharmacology*; D014859:Warfarin / Q000097:blood*
chemical_list: D001798:Blood Proteins; D006016:Glycolates; D014859:Warfarin; D013989:Ticrynafen