ELLIS LADER, M.D.; LEE YANG, B.A.; ALLAN CLARKE, R. PH.
To the editor: A cause of warfarin antagonism is unappreciated inclusion of vitamin K analogues in commercial dietary supplements. The following case report is pertinent to this point.
A 60-year-old woman had undergone aortic-valve replacement surgery 15 years before admission and had been anticoagulated thereafter with sodium warfarin. Satisfactory anticoagulation has been maintained chronically with daily administration of 5 mg of warfarin. With institution of dietary supplementation with Osmolite (Ross Laboratories, Columbus, Ohio), up to 1200 mL (12 kcal) daily, the patient's prothrombin time fell to control levels within 1 week. Stepwise increments in her daily warfarin dose to 15
LADER E, YANG L, CLARKE A. Warfarin Dosage and Vitamin K in Osmolite. Ann Intern Med. ;93:373–374. doi: 10.7326/0003-4819-93-2-373_3
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Published: Ann Intern Med. 1980;93(2):373-374.
Cardiology, Valvular Heart Disease.
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