Document Detail

Interaction between terbinafine and warfarin.
MedLine Citation:
PMID:  9568423     Owner:  NLM     Status:  MEDLINE    
A 71-year-old woman presented with gastrointestinal bleeding. She had been stabilized on warfarin for the previous few months. Terbinafine had been started 32 days prior to this episode for the treatment of onychomycosis. The patient had been on cimetidine for the previous 2 years and on other medications for the last 10 years. At the time of admission for the gastrointestinal bleeding, the coagulation indices were all above the therapeutic range. Endoscopy of the gastrointestinal tract exhibited diffuse intestinal 'oozing' consistent with coagulopathy as the cause of bleeding. Terbinafine may have had an effect on the metabolism of warfarin since both are metabolized through the liver and cimetidine can reduce terbinafine clearance by 33% resulting in higher concentrations of the antifungal agent. Our experience suggests that caution should be exercised when prescribing terbinafine to a patient receiving warfarin.
A K Gupta; G S Ross
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Dermatology (Basel, Switzerland)     Volume:  196     ISSN:  1018-8665     ISO Abbreviation:  Dermatology (Basel)     Publication Date:  1998  
Date Detail:
Created Date:  1998-06-08     Completed Date:  1998-06-08     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9203244     Medline TA:  Dermatology     Country:  SWITZERLAND    
Other Details:
Languages:  eng     Pagination:  266-7     Citation Subset:  IM    
Department of Medicine, Sunnybrook Health Science Center, Ont., Canada.
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MeSH Terms
Anticoagulants / administration & dosage,  adverse effects*,  therapeutic use
Antifungal Agents / administration & dosage,  adverse effects*,  therapeutic use
Drug Interactions
Gastrointestinal Diseases / chemically induced
Hemorrhage / chemically induced
Naphthalenes / administration & dosage,  adverse effects*,  therapeutic use
Onychomycosis / drug therapy
Thrombosis / drug therapy
Warfarin / administration & dosage,  adverse effects*,  therapeutic use
Reg. No./Substance:
0/Anticoagulants; 0/Antifungal Agents; 0/Naphthalenes; 81-81-2/Warfarin; 91161-71-6/terbinafine

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

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