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Possible interaction between ciprofloxacin and warfarin.

A K Kamada1

  • 1Pharmacy Service, Veterans Administration Medical Center, Denver, CO.

DICP : the Annals of Pharmacotherapy
|January 1, 1990
PubMed
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Ciprofloxacin significantly increased warfarin

Area of Science:

  • Pharmacology
  • Clinical Medicine

Background:

  • Warfarin is a common anticoagulant for venous thromboembolism.
  • Maintaining therapeutic anticoagulation requires regular monitoring of prothrombin time (PT).

Observation:

  • A patient on stable warfarin therapy (2.5 mg/d) experienced elevated PT levels after initiating ciprofloxacin (500 mg bid).
  • The patient's PT increased from 15.5 sec (1.29 x control) to 22 sec (1.83 x control) within one week of ciprofloxacin use.

Findings:

  • Ciprofloxacin significantly potentiated the anticoagulant effect of warfarin.
  • No other confounding factors were identified for the observed increase in PT.

Implications:

  • Concurrent use of ciprofloxacin and warfarin necessitates close prothrombin time monitoring.

Related Experiment Videos

  • Clinicians should be prepared to adjust warfarin dosage when these medications are co-administered.