Key Laboratory of Clinical Trial Research in Cardiovascular Drugs， Ministry of Health， Cardiovascular Institute and Fuwai Hospital， Peking Union Medical College and Chinese Academy of Medical Science， Beijing 10037， China
OBJECTIVE To evaluate the effect of amiodarone on warfarin initial anticoagulation response within the first week in the patients with heart valve replacement. METHODS The differences in the total warfarin dose of the first 5 d， INR within the therapeutic window in day 6 and the time to first INR in therapeutic range after operation were compared between the patients who took warfarin only and combining use of amiodarone. RESULTS The total warfarin dose of the first 5 d was lower in warfarin group than that of warfarin and amiodarone group. The combining use of amiodarone was not associated with INR within the therapeutic window in day 6 after operation and the time to first INR in therapeutic range. CONCLUSION Amiodarone does not affect the initial anticoagulation response of warfarin within the first week in patients with heart valve replacement.
XIE Shung;LIU Hong;LOU Ying;HUNG Yi-ling;JING Jun-jun;XU Li;LI Yi-shi.
Effects of Amiodarone Dose on the Initial Anticoagulation Response of Warfarin Within 1 Week in Patients with Heart Valve Replacement[J]. Chinese Pharmaceutical Journal, 2010, 45(8): 593-596
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
［1］ O’REILLY R A， TRAGER W F， RETTIE A E， et al. Interaction of amiodarone with racemic warfarin and its separated enantiomorphs in humans ［J］. Clin Pharmacol Ther，1997，42（3）：290-294. ［2］ WATT A H， STEPHENS M R， BUSS D C， et al. Amiodarone reduces plasma warfarin clearance in man［J］. Br J Clin Pharmacol， 1985，20（6）：707-709. ［3］ CHEUNG B， LAM F M， KUMANA C R. Insidiously evolving， occult drug interaction involving warfarin and amiodarone［J］. BMJ，1996， 312（7023）：107-108. ［4］ SANOSKI C A， BAUMAN J L. Clinical observations with the amiodarone/warfarin interaction［J］. Chest， 2002，121（1）：19-23. ［5］ HIRSH J， FUSTER V， ANSELL J， et al. American heart association / amerian college of cardiology foundation guide to warfarin therapy［J］. Circulation， 2003，107（102）：1692-1711. ［6］ MIAO L， YANG J， HUANG C， et al. Contribution of age， body weight， and CYP2C9 and VKORC1 genotype to the anticoagulant response to warfarin： proposal for a new dosing regimen in Chinese patients［J］. Eur J Clin Pharmacol， 2007，63（12）：1135-1141. ［7］ RIEDER M J， REINER A P， GAGE B F， et al. Effect of VKORC1 haplotypes on transcriptional regulation and warfarin dose［J］. N Engl J Med， 2005，352（22）：2285-2293. ［8］ WADELIUS M， CHEN L Y， LINDH J D， et al. The largest prospective warfarin-treated cohort supports genetic forecasting［J］. Blood， 2009，113（4）：784-792. ［9］ KERIN N Z， BLEVINS R D， GOLDMAN L， et al. The incidence， magnitude， and time course of the amiodarone-warfarin interaction［J］. Arch Intern Med，1988， 148（8）：1779-1781. ［10］ OHYAMA K， NAKAJIMA M， SUZUKI M， et al. Inhibitory effects of amiodarone and its N-deethylated metabolite on human cytochrome P450 activities： prediction of （in vivo） drug interactions［J］. Br J Clin Pharmacol， 2000，49（3）：244-253. ［11］ HEIMARK L D， WIENKERS L， KUNZE K， et al. The mechanism of the interaction between amiodarone and warfarin in humans［J］. Clin Pharmacol Ther， 1992，51（4）：398-407. ［12］ BRECKENRIDGE A， ORME M. Kinetics of warfarin absorption in man［J］. Clin Pharmacol Ther，1973，14（6）：955-961. ［13］ BRECKENRIDGE A， ORME M， WESSELING H， et al. Pharmacokinetics an pharmacodynamics of the enantiomers of warfarin in man［J］. Clin Pharmacol Ther， 1974，15（4）：424-430. ［14］ DARJA H， IGOR L， IZTOK G， et al. The influence of co-treatment with carbamazepine， amidarone and statins on warfarin metabolism and maintenance dose［J］. Eur J Pharmacol，2006，62（4）：291-296. ［15］ YAO J D， JIANG Y F， ZHAO F， et al. Amiodarone increased anticoagulation of warfarin［J］. Clin Focus(临床荟萃)，2006，21（11）：810-811.
PDF(784 KB)
