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WHAT IS ALREADY KNOWN ABOUT THIS SUBJECTCase reports suggest an association between cranberry juice and potentiation of warfarin. Studies using 240 ml of cranberry juice daily demonstrated no interaction. It is unknown if higher amounts of cranberry juice will interact with warfarin. WHAT THIS STUDY ADDSCranberry juice at 240 ml twice daily does not alter the pharmacodynamics of warfarin. AIMTo determine if high-dose cranberry juice (240 ml twice daily) alters the pharmacodynamic action of warfarin. METHODSTen male patients taking stable doses of warfarin were given cranberry juice at 240 ml twice daily for 7 days. Prothrombin times were drawn at baseline and days 2, 6 and 8 after administration of the juice. Prothrombin times were averaged for each day and mean times were compared from each study day to baseline using repeated measures ANOVA. RESULTSThere was no statistical difference between mean prothrombin time at baseline and any day tested during juice administration. CONCLUSIONSCranberry juice (240 ml twice daily for 1 week) did not alter the pharmacodynamics of warfarin in patients.

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The purpose of this study was to assess the effect of fluoxetine on the hypoprothrombinemic response of warfarin in patients chronically anticoagulated. Patients receiving low-intensity anticoagulation with warfarin were recruited. All patients were taking stable dosages of warfarin and had two baseline prothrombin times (PTs) within 10% of each other. Each patient received fluoxetine (20 mg daily) for 21 days. PTs were measured on days 2, 5, 8, 12, 15, 19, and 22 of fluoxetine administration. Six patients completed the study. There was no significant difference in mean PTs before and during fluoxetine administration. Fluoxetine at the dosage studied does not predictably effect the hypoprothrombinemic response of warfarin.

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