title: Warfarin: pharmacological profile and drug interactions with antidepressants.
abstract: Oral anticoagulants are among the drugs with the greatest number of drug interactions. The concomitant use of several medications is a common practice in patients with cardiovascular problems, who often also present with depression; therefore, the probability of an interaction occurring between warfarin and the antidepressants is high, and may result in increased or decreased anticoagulant activity. Since the possible interactions between these two classes of drugs have been poorly explored in literature, with a risk to the patients who use them, we reviewed the pharmacology of warfarin and its possible interactions with antidepressants. Of the antidepressants analyzed, those that showed relevant effects on the interaction with warfarin were, in decreasing order: paroxetine, venlafaxine, fluoxetine, and duloxetine.
authors.affiliation: Undergraduate Course of Medicine, Faculdade de Medicina do ABC - FMABC, Santo Andre (SP), Brazil.
authors.forename: Juliana Souto
authors.initials: JS
authors.lastname: Teles
authors.forename: Ellen Yukie
authors.initials: EY
authors.lastname: Fukuda
authors.forename: David
authors.initials: D
authors.lastname: Feder
mesh_terms: D000284:Administration, Oral; D000925:Anticoagulants / Q000009:adverse effects / Q000493:pharmacokinetics / Q000494:pharmacology* / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000494:pharmacology*; D001711:Biotransformation / Q000187:drug effects; D003511:Cyclohexanols / Q000494:pharmacology; D003577:Cytochrome P-450 Enzyme System / Q000378:metabolism; D004347:Drug Interactions; D000068736:Duloxetine Hydrochloride; D005473:Fluoxetine / Q000494:pharmacology; D006470:Hemorrhage / Q000139:chemically induced; D006801:Humans; D017374:Paroxetine / Q000494:pharmacology; D013876:Thiophenes / Q000494:pharmacology; D019851:Thrombophilia / Q000188:drug therapy; D000069470:Venlafaxine Hydrochloride; D014812:Vitamin K / Q000037:antagonists & inhibitors; D014859:Warfarin / Q000009:adverse effects / Q000493:pharmacokinetics / Q000494:pharmacology* / Q000627:therapeutic use
chemical_list: D000925:Anticoagulants; D000928:Antidepressive Agents; D003511:Cyclohexanols; D013876:Thiophenes; D005473:Fluoxetine; D014812:Vitamin K; D017374:Paroxetine; D014859:Warfarin; D000069470:Venlafaxine Hydrochloride; D003577:Cytochrome P-450 Enzyme System; D000068736:Duloxetine Hydrochloride