An adverse interaction between warfarin and 5-fluorouracil: A case report and review of the literature.
Adverse interactions between warfarin and 5-fluorouracil (5-FU) have been reported. Such an interaction occurred in a patient with lung cancer receiving vinblastine and 5-FU. This case is the first involving a patient taking minidose warfarin for prophylaxis of catheter-associated thrombosis. Although the mechanism of the interaction is unclear, it has been postulated that 5-FU interferes with the synthesis of hepatic cytochrome P-450 2C9. Because warfarin and 5-FU are regularly coadministered, this adverse interaction might be occurring more frequently than is realized. Clinicians should be aware of this interaction and should regularly monitor the prothrombin time of patients receiving warfarin and 5-FU.
Brown
M C
MC
Division of Gastroenterology, Department of Medicine, University of Washington, Seattle, Wash., USA. mcbrown@u.washington.edu
D000925:Anticoagulants / Q000008:administration & dosage / Q000009:adverse effects*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000556:secondary; D016190:Carboplatin / Q000008:administration & dosage; D018288:Carcinoma, Small Cell / Q000188:drug therapy / Q000556:secondary; D002404:Catheterization / Q000009:adverse effects; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D004347:Drug Interactions; D005047:Etoposide / Q000008:administration & dosage; D017809:Fatal Outcome; D005472:Fluorouracil / Q000008:administration & dosage*; D006801:Humans; D006932:Hyperbilirubinemia / Q000139:chemically induced*; D007261:Infusions, Intra-Arterial; D007262:Infusions, Intravenous; D007565:Jaundice / Q000139:chemically induced* / Q000188:drug therapy; D008113:Liver Neoplasms / Q000556:secondary; D008175:Lung Neoplasms / Q000188:drug therapy; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D008937:Mitomycins / Q000008:administration & dosage; D017239:Paclitaxel / Q000008:administration & dosage; D013927:Thrombosis / Q000209:etiology / Q000517:prevention & control; D014747:Vinblastine / Q000008:administration & dosage; D014750:Vincristine / Q000008:administration & dosage; D014859:Warfarin / Q000008:administration & dosage / Q000009:adverse effects*
D000925:Anticoagulants; D008937:Mitomycins; D014750:Vincristine; D014859:Warfarin; D014747:Vinblastine; D005047:Etoposide; D004317:Doxorubicin; D003520:Cyclophosphamide; D016190:Carboplatin; D017239:Paclitaxel; D005472:Fluorouracil