Gastrointestinal bleeding caused by drinking water soaked with dandelion during warfarin administration
10.3760/cma.j.cn114015-20200203-00077
- VernacularTitle:服用华法林期间饮用蒲公英水致消化道出血
- Author:
Liyan WANG
1
;
Yanwei CHEN
1
;
Yunming LI
1
Author Information
1. 大连医科大学附属第一医院药学部，大连 116011
- Publication Type:Journal Article
- Keywords:
Warfarin;
Taraxacum;
Drugs, Chinese herbal;
Herb-drug interactions
- From:
Adverse Drug Reactions Journal
2020;22(11):650-651
- CountryChina
- Language:Chinese
-
Abstract:
A 55-year-old male patient with severe mitral valve insufficiency received long-time warfarin anticoagulation therapy after mechanical mitral valve replacement and the international standard ratio (INR) was 2.00-3.00. Because of oral ulcers, he took the water soaked with dandelion ( Taraxacum mongolicum Hand-Mass.), which was self-purchased and sun-dried, for daily drinking. Fifteen days later, the patient developed chest tightness, shortness of breath, palpitation, and fatigue, followed by nausea, vomiting, mild edema of the lower limbs, orthopnea at night, ecchymosis on the right lower limb, and black stool successively. Laboratory tests showed hemoglobin 52 g/L, red blood cell count 2.05×10 12/L. Gastrointestinal bleeding was considered, which might be related to the water soaked with dandelion drunk during warfarin therapy. Warfarin and water soaked with dandelion were stopped. The patient received symptomatic treatments including IV infusions of leukocyte-depleted red blood cell suspension 2 units (2 times in total) and esomeprazole 80 mg (twice daily), an intramuscular injection of vitamin K 1 10 mg, and oral vitamin K 1 20 mg. Two days later, the patient′s INR was 1.58, hemoglobin was 84 g/L, and red blood cell count was 2.33×10 12/L. Five days later, his INR was 1.63, hemoglobin was 104 g/L, and red blood cell count was 3.92×10 12/L.
