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Simultaneous use of amiodarone influences warfarin maintenance dose but is not associated with adverse events.
- Source :
-
Journal of managed care & specialty pharmacy [J Manag Care Spec Pharm] 2014 Apr; Vol. 20 (4), pp. 376-81. - Publication Year :
- 2014
-
Abstract
- Background: Drug interaction studies selecting patients in a real-life setting are scarce, and most studies to date are characterized by a small sample size.<br />Objective: To evaluate the effect of amiodarone on warfarin maintenance dose and adverse events in an anticoagulation cohort from a tertiary cardiovascular service.<br />Methods: This study recruited 866 patients, and oral anticoagulant therapy was monitored by the prothrombin time expressed as the international normalized ratio (INR). Genotyping of CYP2C9*2, CYP2C9*3, and VKORC1 3673 polymorphisms was performed.<br />Results: Of the 866 patients, 111 (12.8%) were taking amiodarone and warfarin simultaneously, and 514 (59.4%) reached the therapeutic target dose. The warfarin maintenance dose was significantly lower in patients simultaneously using amiodarone (23.8 ± 11.3 mg/wk) compared with other patients (29.5 ± 14.3 mg/wk; P < 0.001). Patients taking amiodarone had higher INR/current dose ratios (0.83 ± 0.04 per mg) compared with patients not using amiodarone (0.71 ± 0.02 per mg, P = 0.001). Adverse event frequency was not different between the groups (P = 0.40). No genotype effect was noted on the odds of bleeding associated with amiodarone use.<br />Conclusions: Simultaneous use of amiodarone influences warfarin maintenance dose, but is not associated with adverse events.
- Subjects :
- Aged
Amiodarone administration & dosage
Amiodarone adverse effects
Anti-Arrhythmia Agents administration & dosage
Anti-Arrhythmia Agents adverse effects
Anticoagulants administration & dosage
Anticoagulants adverse effects
Cohort Studies
Cytochrome P-450 CYP2C9 genetics
Dose-Response Relationship, Drug
Female
Genotype
Humans
International Normalized Ratio
Male
Middle Aged
Polymorphism, Genetic
Prothrombin Time
Retrospective Studies
Vitamin K Epoxide Reductases genetics
Warfarin administration & dosage
Warfarin adverse effects
Amiodarone pharmacology
Anti-Arrhythmia Agents pharmacology
Anticoagulants pharmacology
Warfarin pharmacology
Subjects
Details
- Language :
- English
- ISSN :
- 2376-1032
- Volume :
- 20
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Journal of managed care & specialty pharmacy
- Publication Type :
- Academic Journal
- Accession number :
- 24684642
- Full Text :
- https://doi.org/10.18553/jmcp.2014.20.4.376