title: [Gastrointestinal hemorrhage associated with concurrent use of sorafenib and warfarin for hepatocellular carcinoma].
abstract: A 60-year-old man with liver cirrhosis caused by hepatitis C, who was receiving warfarin anticoagulation following acute myocardial infarction, was diagnosed with advanced hepatocellular carcinoma and multiple lung metastases, and began treatment with sorafenib 200 mg daily. From the treatment's start to 14 and 63 days later, sorafenib was increased to 400 mg and 600 mg, respectively. After increasing the quantity to 600 mg, he had an increase in PT-INR values and experienced a lower-extremity hemorrhage. For the patient with liver cirrhosis, who is receiving warfarin, PT-INR values might be elevated during the early period of sorafenib treatment dosage as for the increase in quantity. Therefore, when increasing dosage, a frequent measurement of PT-INR and a careful follow-up for PT-INR is necessary.
authors: Division of Gastroenterology and Hepatology, Toho University Medical Center, Omori Hospital, Japan.
authors: Kazue
authors: K
authors: Shiozawa
authors: Manabu
authors: M
authors: Watanabe
authors: Naoki
authors: N
authors: Hirano
authors: Noritaka
authors: N
authors: Wakui
authors: Yoshinori
authors: Y
authors: Kikuchi
authors: Fumihiko
authors: F
authors: Hara
authors: Koji
authors: K
authors: Ishii
authors: Kazunari
authors: K
authors: Iida
authors: Yasukiyo
authors: Y
authors: Sumino
mesh_terms: D000925:Anticoagulants / Q000009:adverse effects* / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001557:Benzenesulfonates / Q000009:adverse effects* / Q000627:therapeutic use; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy*; D004359:Drug Therapy, Combination / Q000009:adverse effects; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced*; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009536:Niacinamide / Q000031:analogs & derivatives; D010671:Phenylurea Compounds; D011725:Pyridines / Q000009:adverse effects* / Q000627:therapeutic use; D000077157:Sorafenib; D014057:Tomography, X-Ray Computed; D014859:Warfarin / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D000925:Anticoagulants; D000970:Antineoplastic Agents; D001557:Benzenesulfonates; D010671:Phenylurea Compounds; D011725:Pyridines; D009536:Niacinamide; D014859:Warfarin; D000077157:Sorafenib