Drug Interaction Between Favipiravir and Warfarin: A Case Series

IF 0.8 Q4 PHARMACOLOGY & PHARMACY
S. Pornwattanakavee, Watcharapong Priksri, Authakorn Aonkhum, Nattawut Leelakanok, Bannawich Sapapsap
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Abstract

Introduction: Initiating favipiravir in COVID-19 patients with long-term warfarin use can lead to increased INR. However, data on the onset and duration of the increasing INR are limited. Method: We reviewed patient charts to include COVID-19 adult patients who received favipiravir for at least 5 days and used warfarin at the same dose for at least 12 weeks. Data on demographics, comorbidities, other medical characteristics, international normalized ratio (INR), and signs of bleeding were collected. Result: Eight patients, with a mean age of 70.88 ± 8.49 years old, received the standard dose of favipiravir. The mean maximum INR (4.30 ± 1.26) was statistically different from the baseline INR ( P = .00029) and the change was observed within 4.38 ± 1.99 days after initiating favipiravir. Warfarin was then discontinued without favipiravir discontinuation in most patients, allowing the INR to gradually decrease within 2 to 3 days. Conclusion: Concurrent use of favipiravir and warfarin led to INR prolongation within approximately 4 days. The effect of such interaction can be acute as the prolongation occurred within 1 day in 1 of the patients.
法匹拉韦和华法林之间的药物相互作用:一个病例系列
简介:长期服用华法林的 COVID-19 患者开始服用法非拉韦可能会导致 INR 增高。然而,有关 INR 增高的起始时间和持续时间的数据十分有限。方法:我们查阅了患者病历,纳入了接受法非吡韦治疗至少 5 天并以相同剂量使用华法林至少 12 周的 COVID-19 成人患者。我们收集了有关人口统计学、合并症、其他医疗特征、国际标准化比值 (INR) 和出血迹象的数据。研究结果八名患者接受了标准剂量的法非拉韦治疗,平均年龄(70.88±8.49)岁。平均最大 INR(4.30 ± 1.26)与基线 INR 存在统计学差异(P = .00029),并且在开始服用法非拉韦后的 4.38 ± 1.99 天内出现了变化。大多数患者随后停用了华法林而没有停用法非拉韦,从而使 INR 在 2 到 3 天内逐渐下降。结论同时服用法非拉韦和华法林会导致 INR 在大约 4 天内延长。这种相互作用的影响可能是急性的,因为其中一名患者在 1 天内就出现了 INR 延长。
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来源期刊
Hospital Pharmacy
Hospital Pharmacy PHARMACOLOGY & PHARMACY-
CiteScore
1.70
自引率
0.00%
发文量
63
期刊介绍: Hospital Pharmacy is a monthly peer-reviewed journal that is read by pharmacists and other providers practicing in the inpatient and outpatient setting within hospitals, long-term care facilities, home care, and other health-system settings The Hospital Pharmacy Assistant Editor, Michael R. Cohen, RPh, MS, DSc, FASHP, is author of a Medication Error Report Analysis and founder of The Institute for Safe Medication Practices (ISMP), a nonprofit organization that provides education about adverse drug events and their prevention.
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