Prolonged prothrombin time caused by the combination of iguratimod and warfarin
10.3760/cma.j.cn114015-20220822-00771-1
- VernacularTitle:艾拉莫德与华法林联用致血浆凝血酶原时间延长
- Author:
Hongtao ZHANG
1
;
Zhikui WANG
Author Information
1. 锦州医科大学研究生学院，锦州 121001
- Publication Type:Journal Article
- Keywords:
Antirheumatic agents;
Warfarin;
Prothrombin time;
Drug therapy, combination;
Iguratimod
- From:
Adverse Drug Reactions Journal
2023;25(2):122-125
- CountryChina
- Language:Chinese
-
Abstract:
A 59-year-old female patient received treatments of improvement of heart function, anti-rheumatism (oral total glucoside of white paeony capsules 0.6 g twice daily, oral iguratimod 25 mg twice daily), and anti-infection, etc. due to rheumatic heart disease, acute exacerbation of chronic cardiac dysfunction, rheumatoid arthritis, and pulmonary infection. Before medication, the prothrombin time (PT) was 15.5 s, and the international normalized ratio (INR) was 1.2. Considering that the patient had valvular heart disease and mural thrombus in the left atrium, oral warfarin 2.5 mg once daily was added the next day. PT was prolonged and INR increased. On the 10th day of warfarin application, her PT was 45.0 s and INR was 4.8. Warfarin was discontinued and the dose of iguratimod was reduced to 25 mg orally once daily. On the 2nd day of warfarin discontinuation, PT was 53.2 s and INR was 5.9; on the 3rd day, PT was 80.8 s and INR was 10.1. Then iguratimod was stopped and vitamin K 1 was given. After 3 days, the PT was 22.4 s and INR was 2.0. Later, oral warfarin 2 mg once daily was added due to the disease condition. The PT was 19.8 to 27.4 s and INR was 2.1 to 2.9. It was considered that the prolonged PT in the patients might be related to the combination of iguratimod and warfarin.
