title: Probable acenocoumarol-amoxycillin interaction.
abstract: We present the case of a woman undergoing treatment with acenocoumarol for deep vein thrombosis, who maintained an international normalized ratio (INR) of between 2.5 and 4 for 2 months. Seven days after the introduction of amoxycillin (500 mg/8 h) for a probable respiratory infection, the patient developed spontaneous bruising, with an INR of 7.1. Treatment with amoxycillin was discontinued, and 3 weeks later the INR had returned to previous values. In this case, the increase in the INR value with associated bruising after the addition of amoxycillin suggests a drug interaction between acenocoumarol and amoxycillin, other possible causes having been eliminated.
authors.affiliation: Clinical Pharmacology Unit, Hospital Santa Cruz, Liencres-Cantabria, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Soto
authors.forename: J A
authors.initials: JA
authors.lastname: Sacristan
authors.forename: M J
authors.initials: MJ
authors.lastname: Alsar
authors.forename: C
authors.initials: C
authors.lastname: Fernandez-Viadero
authors.forename: R
authors.initials: R
authors.lastname: Verduga
mesh_terms: D000074:Acenocoumarol / Q000008:administration & dosage / Q000009:adverse effects*; D000368:Aged; D000369:Aged, 80 and over; D000658:Amoxicillin / Q000009:adverse effects*; D004347:Drug Interactions; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D011183:Postoperative Complications / Q000097:blood / Q000188:drug therapy; D012141:Respiratory Tract Infections / Q000097:blood / Q000188:drug therapy; D013924:Thrombophlebitis / Q000097:blood / Q000188:drug therapy; D013997:Time Factors
chemical_list: D000658:Amoxicillin; D000074:Acenocoumarol