Drug interactions may need change in warfarin dose
A reduction or an increase in warfarin dose may be necessary when patients taking anticoagulants also receive hypnotics or sedatives
The administration of hypnotics or sedatives to patients on long-term anticoagulant therapy may require a change in the dose of sodium warfarin, two groups of investigators warned at an international Conference on Drug Metabolism in Man.
Chloral hydrate, a widely-used sedative, potentiates the effects of sodium warfarin and may require a reduction in dose in order to prevent excessive hypoprothrombinemia and bleeding, report Harvard Medical School pharmacologists.
British physicians Alasdair Breckenridge, MSc, MB, MRCP, and Michael Orwe, MB, MRCP, suggest that some sedatives and hypnotics speed up metabolism of warfarin, making an increase in dose necessary to maintain anticoagulant control and the desired plasma warfarin level.
The Harvard investigators, Edward Sellers, MD, and Jan Koch-Weser, MD, have observed potentiation of warfarin's hypoprothrombinemic
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