JAN KOCH-WESER, M.D.; EDWARD M. SELLERS, M.D.
To the editor: During their carefully controlled study, reported in the April 1971 ANNALS, Dr. Griner and associates found that hypoprothrombinemic responses to warfarin were not chronically altered by concomitant administration of chloral hydrate. We reported previously that giving chloral hydrate to subjects stably anticoagulated with warfarin quickly enhances their hypoprothrombinemia (1). This potentiation is caused by displacement of warfarin from plasma albumin by trichloroacetic acid, a major metabolite of chloral hydrate, and is accompanied by a shortened warfarin halflife (1-3). We have since confirmed these observations in five more subjects studied in the same fashion. We do not believe
KOCH-WESER J, SELLERS EM. Chloral Hydrate and Warfarin Therapy. Ann Intern Med. ;75:141–142. doi: 10.7326/0003-4819-75-1-141
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Published: Ann Intern Med. 1971;75(1):141-142.
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