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Related Experiment Videos

Capecitabine-warfarin interaction.

Laurel M Janney1, Nancee V Waterbury

  • 1Department of Pharmacy Service, Iowa City Veterans Affairs Medical Center, Iowa City, IA 52246-2208, USA. Laurel.Janney@med.va.gov

The Annals of Pharmacotherapy
|July 15, 2005
PubMed
Summary
This summary is machine-generated.

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Capecitabine significantly interacts with warfarin, necessitating substantial dose reductions (>85%) to maintain therapeutic anticoagulation. Close patient monitoring is crucial for safe co-administration of these drugs.

Area of Science:

  • Oncology
  • Pharmacology
  • Internal Medicine

Background:

  • Chemotherapy agents like capecitabine are increasingly used in patients requiring anticoagulation.
  • Warfarin is a common oral anticoagulant used for mechanical heart valves and other conditions.

Observation:

  • A patient on warfarin for a mechanical mitral valve replacement developed metastatic colon cancer.
  • The patient received capecitabine/irinotecan chemotherapy concurrently with warfarin.
  • Warfarin dose requirements decreased by over 85% across three cycles of capecitabine therapy.

Findings:

  • A clinically significant drug interaction between capecitabine and warfarin was observed.
  • The interaction required substantial warfarin dose adjustments to maintain therapeutic anticoagulation.

Related Experiment Videos

  • The Naranjo probability scale indicated a highly probable interaction.

    • Implications:

    • This interaction may necessitate a black box warning for capecitabine.
    • The mechanism may involve CYP2C9 down-regulation or pharmacodynamic effects.
    • Close monitoring allows for the safe concurrent use of capecitabine and warfarin in select patients.