Acenocoumarol Mercaptopurine

Azathioprine or mercaptopurine have been sometimes involved in reduced warfarin and acenocoumarol activity, and increased warfarin dosages may be necessary (103). Similar findings were found in a patient taking maintenance phenprocoumon (SEDA-21, 382). 

Fernandez MA, Regadera A, Aznar J. Acenocoumarol and 6-mercaptopurine an important drug interaction. Haematologica 1999 84(7) 664-5. 

Clinically important, potentially hazardous interactions with acenocoumarol, amoxicillin, ampicillin, azathioprine, dicumarol, imidapril, mercaptopurine, pantoprazole, uracil/tegafur, vidarabine, zofenopril... 

A number of case reports describe an increase in the effects of warfarin, accompanied by bleeding in some cases, caused by an-tineoplastic regimens containing carboplatin, chlormethine, cyclophosphamide, doxorubicin, etoposide, gefitinib, gemcitabine, ifosfamide with mesna, methotrexate, procarbazine, trastuzum-ab, vincristine or vindesine. A decrease in the effects of warfarin has been seen with azathioprine, cyclophosphamide, mercaptop-urine and mitotane, a decrease in the effects of acenocoumarol has been seen with mercaptopurine, and a decrease in the effects of phenprocoumon have l n seen with azathioprine. 

A man well stabilised on warfarin had a marked reduction in his anticoagulant response on two occasions while taking mercaptopurine, but no changes occurred when he took busulfan, cyclophosphamide, cytarab-ine, hydroxycarbamide, mitobronitol, demecolcine or melphalan. A woman needed a marked increase in her dosage of acenocoumarol, from 21 to 70 mg weekly, when she was given mercaptopurine 100 mg daily. Another patient required about a 25% increase in warfarin dose while taking mercaptopurine 1(X) mg daily. 

---

See also in sourсe #XX -- [ ]

---