Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Experiment Videos

Bosentan and warfarin interaction.

Lisa M Murphey1, Elizabeth H Hood

  • 1School of Pharmacy, University of Mississippi, Jackson, MS, USA. lmurphey@pharmacy.umsmed.edu

The Annals of Pharmacotherapy
|July 5, 2003
PubMed
Summary
This summary is machine-generated.

Related Concept Videos

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

A comparison of diabetes care in rural and urban medical clinics in Alabama.

Journal of community health·2004
Same journal

Severe Phototoxic Skin Reaction Associated With Vandetanib: Implications for Pharmaceutical Care.

The Annals of pharmacotherapy·2026
Same journal

Efficacy and Safety of Oral PCSK9 Inhibitors in Adults With Hypercholesterolemia: An Updated Systematic Review and Meta-Analysis of RCTs.

The Annals of pharmacotherapy·2026
Same journal

RSVpreF: A Vaccine for the Respiratory Syncytial Virus.

The Annals of pharmacotherapy·2026
Same journal

Severe Acute Hepatitis Induced by Combined Rosuvastatin and Ticagrelor Therapy Post-PCI: The Challenges of Multi-Drug DILI Diagnosis.

The Annals of pharmacotherapy·2026
Same journal

Modified vs Full Lead-in Dose Apixaban and Rivaroxaban for Treatment of Acute Venous Thromboembolism.

The Annals of pharmacotherapy·2026
Same journal

A Comparison of Phenobarbital Dosing Strategies for the Treatment of Alcohol Withdrawal Syndrome.

The Annals of pharmacotherapy·2026
See all related articles

Bosentan may decrease warfarin effectiveness, leading to a significant increase in warfarin dosage requirements. Close monitoring of the international normalized ratio (INR) is crucial when initiating or adjusting bosentan therapy in patients on warfarin.

Area of Science:

  • Pharmacology
  • Drug Interactions
  • Cardiovascular Medicine

Background:

  • Warfarin is a common anticoagulant used for managing thromboembolic disorders.
  • Bosentan is a dual endothelin receptor antagonist used for pulmonary arterial hypertension.
  • Co-administration of warfarin and bosentan necessitates careful monitoring due to potential interactions.

Observation:

  • A patient on stable warfarin therapy experienced a subtherapeutic international normalized ratio (INR) after initiating bosentan.
  • The INR remained low despite weekly warfarin dose escalations.
  • Following dose adjustments, the INR became supratherapeutic, requiring a warfarin dose reduction.

Findings:

  • A significant drug interaction between bosentan and warfarin was observed, characterized by decreased warfarin efficacy.

Related Experiment Videos

  • The patient required a 63.6% increase in warfarin dosage to maintain a therapeutic INR after starting bosentan.
  • The causality assessment indicated a probable interaction between the two medications.

    • Implications:

    • Bosentan may significantly reduce the anticoagulant effect of warfarin.
    • Healthcare providers should closely monitor INR levels when initiating, adjusting, or discontinuing bosentan in patients receiving warfarin.
    • This case highlights a potentially undocumented but clinically significant drug interaction requiring vigilance.