title: [Increased INR from concomitant use of acenocoumarol and capecitabine].
abstract: BACKGROUND
  A drug interaction between capecitabine and coumarin may result in an increased INR and bleeding complications.
  
  
  METHODS
  We describe an 80-year-old woman who presented with rectal bleeding and an increased INR due to the concomitant use of acenocoumarol and capecitabine for atrial fibrillation and metastatic cecal cancer, respectively.
  
  
  CONCLUSIONS
  In patients with a compelling indication for treatment with capecitabine and anticoagulant therapy, conversion to low-molecular weight heparin should be considered.
authors: Medisch Centrum Alkmaar, Afd. Interne Geneeskunde, the Netherlands. B.Tomlow@mca.nl
authors: Ben
authors: B
authors: Tomlow
authors: Marsha L
authors: ML
authors: Voll
authors: Carolien H
authors: CH
authors: Smorenburg
mesh_terms: D000074:Acenocoumarol / Q000009:adverse effects* / Q000627:therapeutic use; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000009:adverse effects* / Q000627:therapeutic use; D000964:Antimetabolites, Antineoplastic / Q000009:adverse effects* / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000188:drug therapy; D000069287:Capecitabine; D003841:Deoxycytidine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D004347:Drug Interactions; D017707:Erythrocyte Transfusion; D005260:Female; D005472:Fluorouracil / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced*; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006801:Humans; D019934:International Normalized Ratio; D012004:Rectal Neoplasms / Q000188:drug therapy
chemical_list: D000925:Anticoagulants; D000964:Antimetabolites, Antineoplastic; D006495:Heparin, Low-Molecular-Weight; D003841:Deoxycytidine; D000069287:Capecitabine; D000074:Acenocoumarol; D005472:Fluorouracil