Potentiation of the action of warfarin by bezafibrate in patients with the nephrotic syndrome.
Nephrotic syndrome is associated with thromboembolic disease due to a variety of factors. In addition, therapy with anticoagulants is often met with poor response, to warfarin for example, which occurs due to factors such as reduced serum albumin and binding sites, increased free warfarin with rapid metabolism and clearance, and possible urinary loss. Bezafibrate is known to augment the action of warfarin and improve coagulation profile. In this article, we present three cases with severe nephrotic syndrome associated with hyperfibrinogenemia, hypercholesterolemia and thromboembolic disease who showed poor response to therapy with warfarin. They showed improvement of their coagulation profile upon concomitant administration of bezafibrate.
Al-Momen
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Division of Hematology, Department of Medicine, College of Medicine and King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia.
Al-Abdul-Kareem
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H