Griseofulvin-Warfarin Antagonism

Cullen, Stanley I.; Catalano, Philip M.

doi:10.1001/jama.1967.03120080116027

Cited by 59 publications

(3 citation statements)

References 9 publications

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“…The effect of griseofulvin was reported in two healthy patients and two volunteers receiving warfarin. 56 In three subjects the addition of griseofulvin produced a decrease in PT that was attributed to enzyme induction. The effect was reversed with discontinuation of the antifungal agent.…”

Section: Griseo Fulvinmentioning

confidence: 95%

A Review of Enzyme Induction of Warfarin Metabolism with Recommendations for Patient Management

Cropp,

Bussey

1997

Pharmacotherapy

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We conducted a review of literature from the MEDLINE data base (1966‐January 1997), and bibliographies of published articles, reviews, and letters to classify enzyme induction of warfarin metabolism interactions by onset, extent, and offset. Ten hepatic microsomal enzyme agents were assessed. Likelihood of interaction was based on the strength of supporting literature. Enzyme induction of warfarin metabolism by rifampin and barbiturates is considered likely, although the characteristics of the interactions are different. An interaction is probable with carbamazepine, griseofulvin, aminoglutethimide, nafcillin, and dicloxacillin. A suspected interaction may occur with smoking and long‐term alcohol consumption. Ingestion of a small amount of alcohol is unlikely to interact with warfarin. The effect of phenytoin on warfarin metabolism is unpredictable. Anticipation of the expected time course and extent of interaction may allow for better therapeutic decisions and decrease the chance of inappropriate anticoagulation with its potential for complications. (Pharmacotherapy 1997;17(5):917–928)

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Section: Griseo Fulvinmentioning

confidence: 95%

A Review of Enzyme Induction of Warfarin Metabolism with Recommendations for Patient Management

Cropp,

Bussey

1997

Pharmacotherapy

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“…Patients on chronic warfarin therapy starting griseofulvin generally will require higher than baseline doses of warfarin to maintain therapeutic INR. 43…”

Section: Antifungalsmentioning

confidence: 99%

Drug Interactions Affecting Oral Anticoagulant Use

Mar

Gopinathannair

Gengler

et al. 2022

Circ: Arrhythmia and Electrophysiology

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Oral anticoagulants (OACs) are medications commonly used in patients with atrial fibrillation and other cardiovascular conditions. Both warfarin and direct oral anticoagulants are susceptible to drug-drug interactions (DDIs). DDIs are an important cause of adverse drug reactions and exact a large toll on the health care system. DDI for warfarin mainly involve moderate to strong inhibitors/inducers of cytochrome P450 (CYP) 2C9, which is responsible for the elimination of the more potent S-isomer of warfarin. However, inhibitor/inducers of CYP3A4 and CYP1A2 may also cause DDI with warfarin. Recognition of these precipitating agents along with increased frequency of monitoring when these agents are initiated or discontinued will minimize the impact of warfarin DDI. Direct oral anticoagulants are mainly affected by medications strongly affecting the permeability glycoprotein (P-gp), and to a lesser extent, strong CYP3A4 inhibitors/inducers. Dabigatran and edoxaban are affected by P-gp modulation. Strong inducers of CYP3A4 or P-gp should be avoided in all patients taking direct oral anticoagulant unless previously proven to be otherwise safe. Simultaneous strong CYP3A4 and P-gp inhibitors should be avoided in patients taking apixaban and rivaroxaban. Concomitant antiplatelet/anticoagulant use confers additive risk for bleeding, but their combination is unavoidable in many cases. Minimizing duration of concomitant anticoagulant/antiplatelet therapy as indicated by evidence-based clinical guidelines is the best way to reduce the risk of bleeding.

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“…An entirely different kind of complication has involved potentiation of warfarin by disulfiram (Rothstein, 1968) or interference with its action by other drugs including griseofulvin (Cullen and Catalano, 1967) and phenobarbital (Robinson and MacDonald, 1966) or by insecticides. In one case, medical use of warfarin was nullified by use of 5% toxaphene and 1% lindane to dust sheep.…”

Section: (B) Therapeutic Usementioning

confidence: 99%

Rodenticides

Pelfrène¹

2010

Hayes' Handbook of Pesticide Toxicology

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Griseofulvin-Warfarin Antagonism

Cited by 59 publications

References 9 publications

A Review of Enzyme Induction of Warfarin Metabolism with Recommendations for Patient Management

A Review of Enzyme Induction of Warfarin Metabolism with Recommendations for Patient Management

Drug Interactions Affecting Oral Anticoagulant Use

Rodenticides

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