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Interaction between acetaminophen and warfarin in adults receiving long-term oral anticoagulants: a randomized controlled trial.
MedLine Citation:
PMID:  21191575     Owner:  NLM     Status:  Publisher    
PURPOSE: We investigated whether acetaminophen, given at 2 g/day and 3 g/day might potentiate the anticoagulant effect of warfarin. METHODS: Forty-five patients on stable warfarin therapy, enrolled in this prospective, randomized, parallel (three arms), placebo-controlled study, received a 10-day regimen of acetaminophen (2 g/day or 3 g/day) or placebo. RESULTS: The mean maximal INR increase was 0.70 ± 0.49 and 0.67 ± 0.62 in patients receiving acetaminophen at 2 g/day and 3 g/day, respectively (P = 0.01 for the respective comparisons versus placebo). The INR increase became significant on day 3 and was independently and significantly predicted by a maximal decrease in factor II (R (2) = 0.36, P < 0.0001), factor VII (R (2) = 0.46, P < 0.0001) and a maximal increase in acetaminophen plasma concentrations (R (2) = 0.563, P < 0.0001). CONCLUSION: Acetaminophen, at 2 g/day or 3 g/day, enhanced the anticoagulant effect of warfarin in stable patients, thus requiring close INR monitoring in the clinical setting.
Qian Zhang; Claire Bal-Dit-Sollier; Ludovic Drouet; Guy Simoneau; Jean-Claude Alvarez; Sandrine Pruvot; Romain Aubourg; Natacha Berge; Jean-Francois Bergmann; Stéphane Mouly; Isabelle Mahé
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2010-12-30
Journal Detail:
Title:  European journal of clinical pharmacology     Volume:  -     ISSN:  1432-1041     ISO Abbreviation:  -     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-12-30     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  1256165     Medline TA:  Eur J Clin Pharmacol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Unité de Recherches Thérapeutiques-Service de Médecine Interne A, Hôpital Lariboisière, 2 rue Ambroise Paré, 75010, Paris, France.
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