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Updated: Aug 15, 2026

Differential Effects of Lipid-lowering Drugs in Modulating Morphology of Cholesterol Particles
Published on: November 10, 2017
Rosuvastatin-acenocoumarol interaction
Sergio Mondillo1, Piercarlo Ballo, Maurizio Galderisi
1Division of Cardiology, University of Siena, Italy. mondillo@unisi.it
Background:
Previous evidence suggests that hydroxymethylglutaryl coenzyme A-reductase inhibitors (statins) might potentiate the effect of oral anticoagulants, but a MEDLINE search (key terms: stains, rosuvastatin, anticoagulants, acenocoumarol, and interaction; years: 1980-2005) revealed no reports of an interaction between rosuvastatin and acenocoumarol.
Objective:
The aim of this article was to describe a case of possible interaction between rosuvastatin and acenocoumarol.
Methods:
We report the case of a 36-year-old male patient receiving long-term oral treatment with acenocoumarol, a synthetic coumarin anticoagulant, who experienced an increase in international normalized ratio (INR) and a hematoma in the left leg approximately 45 days after the initiation of treatment with rosuvastatin.
Results:
After discontinuation of both drugs, an unexpectedly rapid decrease in INR was observed.
Conclusions:
Based on the results of this case, a possible pharmacologic interaction between rosuvastatin and acenocoumarol should be considered. Rosuvastatin might enhance the anticoagulant effect of acenocoumarol, and a rebound effect in cases of simultaneous discontinuation of both drugs might occur. Rosuvastatin should be administered with extreme caution in patients receiving long-term acenocoumarol therapy.
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