Document Detail

Increase in international normalized ratio after smoking cessation in a patient receiving warfarin.
MedLine Citation:
PMID:  16232028     Owner:  NLM     Status:  MEDLINE    
A 58-year-old man who was taking warfarin at a stable dosage was admitted to the hospital with a diagnosis of bacterial meningitis. Although he had previously been a smoker, after this admission, he decided to give up smoking. He was continued on his previous warfarin maintenance dosage when discharged, and his international normalized ratio (INR) soon began to climb substantially. When questioned, the patient reported no diet or lifestyle changes other than his smoking cessation. The patient's INR was stabilized at a warfarin dosage 23% lower than the maintenance dosage before he stopped smoking. This case report illustrates the potential for an interaction between warfarin and cigarette smoking and further suggests that the effect could be significant if a patient starts or stops smoking during warfarin therapy.
Mark Evans; Geoffrey M Lewis
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Pharmacotherapy     Volume:  25     ISSN:  0277-0008     ISO Abbreviation:  Pharmacotherapy     Publication Date:  2005 Nov 
Date Detail:
Created Date:  2005-10-19     Completed Date:  2006-02-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8111305     Medline TA:  Pharmacotherapy     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1656-9     Citation Subset:  IM    
Pharmacy Department, Ottawa Hospital, Ottawa, Ontario, Canada.
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MeSH Terms
Anticoagulants / pharmacokinetics*
Drug Interactions
Ethanol / pharmacology
International Normalized Ratio*
Middle Aged
Smoking Cessation*
Warfarin / pharmacokinetics*
Reg. No./Substance:
0/Anticoagulants; 64-17-5/Ethanol; 81-81-2/Warfarin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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