Cimetidine Potentiation of the Hypoprothrombinemic Effect of Warfarin
Authors: BRUCE A. SILVER
Journal: Annals of Internal Medicine (1979)

Brief Reports1 March 1979Cimetidine Potentiation of the Hypoprothrombinemic Effect of WarfarinBRUCE A. SILVER, M.D., WILLIAM R. BELL, M.D.BRUCE A. SILVER, M.D.Search for more papers by this author, WILLIAM R. BELL, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-90-3-348 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptOral anticoagulants of the coumarin class are subject to both potentiating and inhibitory drug interactions, some of which are clinically significant (1, 2). We report the case of a patient in whom the combined use of warfarin sodium (Coumadin®, Endo Laboratories, Garden City, New Jersey) and cimetidine (Tagamet®, Smith Kline & French Laboratories, Philadelphia, Pennsylvania) led to excessive hypoprothrombinemia, resulting in soft-tissue and urinary tract hemorrhage. Such an adverse effect of the recently marketed cimetidine has not been reported previously.A 70-year-old white woman presented on 4 October 1978 complaining of pain behind the left knee and gross hematuria. She...References1. MACLEODSELLERS SE: Pharmacodynamic and pharmacokinetic drug interactions with coumarin anticoagulants. Drugs 11:461-470, 1976 CrossrefMedlineGoogle Scholar2. O'REILLYAGGELER RP: Determinants of the response to oral anticoagulant drugs in man. Pharmacol Rev 22:35-96, 1970 MedlineGoogle Scholar3. HENNISENBERGMAXWELLSTURDEVANT RJVR: Inhibition of gastric acid secretion by cimetidine in patients with duodenal ulcer. N Engl J Med 293:371-375, 1975 CrossrefMedlineGoogle Scholar4. LONGSTRETHGOMALAGELADA GVJ: Cimetidine supression of nocturnal gastric secretion in active duodenal ulcer. N Engl J Med 294:801-804, 1976 CrossrefMedlineGoogle Scholar5. FINKELSTEINISSELBACHER WK: Drug therapy: cimetidine. N Engl J Med 299:992-996, 1978 CrossrefMedlineGoogle Scholar6. ELIAS R: Effect of various drugs on anticoagulation dosage, in Anticoagulant Therapy in Ischemic Heart Disease, edited by NICHOL ES, New York, Grune & Stratton, Inc., 1965, pp. 443-448 Google Scholar This content is PDF only. To continue reading please click on the PDF icon. 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RAICH, M.D. 1 March 1979Volume 90, Issue 3Page: 348-349KeywordsBloodCardiology and cardiovascular diseasesCoumarinsDrug interactionsHeartHemorrhageKneesLungsResearch grantsSodium ePublished: 1 December 2008 Issue Published: 1 March 1979 PDF downloadLoading ...