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Warfarin resistance with nafcillin therapy.

G D Qureshi, T P Reinders, G J Somori

Annals of Internal Medicine

|April 1, 1984

Summary

Nafcillin can induce warfarin resistance by increasing its metabolism, leading to reduced effectiveness. This drug interaction necessitates careful monitoring in patients taking both medications.

Area of Science:

Pharmacology
Drug Metabolism
Clinical Pharmacy

Background:

Warfarin is a common anticoagulant medication.
Drug interactions can alter warfarin's efficacy.
Warfarin resistance is a known clinical challenge.

Observation:

A patient on warfarin developed resistance while taking nafcillin.
Warfarin dosage increased to 25 mg/d without achieving therapeutic anticoagulation.
Prothrombin time remained elevated between 14-17 seconds.

Findings:

Nafcillin significantly accelerated warfarin metabolism.
Warfarin's half-life decreased from 44 hours to 11 hours.
This interaction is attributed to enhanced metabolic clearance of warfarin.

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Implications:

Clinically significant drug interaction between nafcillin and warfarin.
Potential for therapeutic failure in patients on combined therapy.
Highlights the importance of monitoring anticoagulation during co-administration.