Multisite mucous membrane bleeding due to a possible interaction between warfarin and 5-fluorouracil.
A 59-year-old man being treated for colon cancer experienced epistaxis, hematemesis, hematuria, and hematochezia. Laboratory evaluation revealed a greatly prolonged prothrombin time. It is possible that the bleeding was due to an interaction between 5-fluorouracil and warfarin. The former may inhibit the synthesis of cytochrome P-4502C9, leading to impaired metabolism of the latter.
Brown
M C
MC
Division of Gastroenterology, University of Washington Medical Center, Seattle 98195, USA.
D000925:Anticoagulants / Q000009:adverse effects* / Q000627:therapeutic use; D000964:Antimetabolites, Antineoplastic / Q000009:adverse effects* / Q000627:therapeutic use; D003110:Colonic Neoplasms / Q000150:complications / Q000188:drug therapy; D004347:Drug Interactions; D004844:Epistaxis / Q000139:chemically induced; D005472:Fluorouracil / Q000009:adverse effects* / Q000627:therapeutic use; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced; D006417:Hematuria / Q000139:chemically induced; D006470:Hemorrhage / Q000097:blood / Q000139:chemically induced*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009092:Mucous Membrane; D011517:Prothrombin Time; D013924:Thrombophlebitis / Q000150:complications / Q000188:drug therapy; D014859:Warfarin / Q000009:adverse effects* / Q000627:therapeutic use
D000925:Anticoagulants; D000964:Antimetabolites, Antineoplastic; D014859:Warfarin; D005472:Fluorouracil