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Probable Interaction Between Warfarin and Divalproex Sodium.

Sarah L Anderson1,2, Joel C Marrs1,2

  • 1University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, CO, USA.

The Journal of Pharmacy Technology : Jpt : Official Publication of the Association of Pharmacy Technicians
|December 3, 2021
PubMed
Summary
This summary is machine-generated.

A potential drug interaction between warfarin and divalproex sodium can increase the international normalized ratio (INR), raising bleeding risk. Close INR monitoring is crucial for patients on both medications.

Keywords:
anticoagulationcytochrome P450divalproex sodiumdrug interactionprotein bindingwarfarin

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Area of Science:

  • Pharmacology
  • Clinical Pharmacy

Background:

  • Warfarin is a common anticoagulant.
  • Divalproex sodium is an anticonvulsant.
  • Potential drug interactions require careful management.

Purpose of the Study:

  • To describe a potential interaction between warfarin and divalproex sodium.
  • To highlight the importance of monitoring international normalized ratio (INR) in patients taking both medications.

Main Methods:

  • A case report of a 65-year-old woman on warfarin therapy.
  • Documented INR changes after the initiation and discontinuation of divalproex sodium.
  • Ruled out other potential causes for INR fluctuations.

Main Results:

  • Initiation of divalproex sodium led to an elevated INR (3.2).
  • Discontinuation of divalproex sodium resulted in a return to therapeutic INR (2.6).
  • The Drug Interaction Probability Scale indicated a probable interaction.

Conclusions:

  • Concurrent use of warfarin and divalproex sodium may increase INR.
  • Increased INR elevates the risk of bleeding.
  • Close INR monitoring is recommended for patients on both drugs.