DONALD S. ROBINSON, M.D.; DAVID SYLWESTER, Ph.D.
The recognition of drugs that interact with warfarin has clinical relevance because of potential serious reactions as a result of the complexities of multiple drug therapy. Because of their frequent use in patients requiring anticoagulant therapy, four drugs—chlordiazepoxide, secobarbital, amobarbital, and chlorothiazide—were studied in eight subjects for possible interaction with warfarin. The administration of hypnotic doses of both barbiturates, secobarbital and amobarbital, significantly accelerated the plasma disappearance and decreased the hypoprothrombinemic effect of warfarin. Neither chlordiazepoxide nor chlorothiazide, administered in standard doses, caused significant alterations in warfarin's action or metabolism. An analysis of variance of the data failed to detect any other effects due to sex, time of year, or sequence of the drugs during the treatment periods. Drugs that can be used safely with warfarin without risk of unpredictable fluctuations in its pharmacologic effect need to be identified.
ROBINSON DS, SYLWESTER D. Interaction of Commonly Prescribed Drugs and Warfarin. Ann Intern Med. 1970;72:853–856. doi: 10.7326/0003-4819-72-6-853
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Published: Ann Intern Med. 1970;72(6):853-856.
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