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Potential interaction between azithromycin and warfarin.

D R Foster1, N L Milan

  • 1College of Pharmacy and Allied Health Professions, Wayne State University, Detroit, Michigan, USA.

Pharmacotherapy
|July 23, 1999
PubMed
Summary
This summary is machine-generated.

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Azithromycin may interact with warfarin, contrary to previous assumptions. A patient experienced a dangerous increase in international normalized ratio (INR) while taking both medications, requiring intervention.

Area of Science:

  • Pharmacology
  • Clinical Medicine

Background:

  • Warfarin is a common anticoagulant.
  • Azithromycin is a macrolide antibiotic.
  • Previous studies suggested no significant drug interaction between azithromycin and warfarin.

Observation:

  • A 71-year-old female patient on warfarin therapy for a prosthetic heart valve developed a significantly elevated INR (15.16).
  • This occurred six days after initiating a 5-day course of azithromycin.
  • The patient's INR was previously stable within the therapeutic range (2.5-3.5).

Findings:

  • The case suggests a potential drug interaction between azithromycin and warfarin.
  • The elevated INR necessitated holding warfarin and administering phytonadione (vitamin K1).
  • Warfarin dosage adjustments may be required when co-administered with azithromycin.

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Implications:

  • Clinicians should exercise caution when prescribing azithromycin to patients on warfarin.
  • Close monitoring of international normalized ratio (INR) is crucial in such cases.
  • Further research is needed to elucidate the mechanism and frequency of this potential interaction.