Lindane Warfarin

Lilly 36352, see Trifluralin Lindafor, see Lindane Lindagam, see Lindane Lindagrain, see Lindane Lindagranox, see Lindane Lindan, see Dichlorvos a-Lindane, see a-BHC p-Lindane, see p-BHC 8-Lindane, see 8-BHC y-Lindane, see Lindane Lindapoudre, see Lindane Lindatox, see Lindane Lindosep, see Lindane Line rider, see 2,4,5-T Lintox, see Lindane Lipan, see 4,6-Dinitro-o-cresol Liroprem, see Pentachlorophenol Liqua-tox, see Warfarin... 

Organochlorine insecticides are also well-known inducers. Treatment of rats with either DDT or chlordane, for example, will decrease hexobarbital sleeping time and offer protection from the toxic effect of warfarin. Persons exposed to DDT and lindane metabolized antipyrine twice as fast as a group not exposed, whereas those exposed to DDT alone had a reduced half-life for phenylbutazone and increased excretion of 6-hydroxy cortisol. 

The past decade has shown that hydrocarbon desaturation is not uncommon but, except in cases such as the biosynthesis of ergosterol, it generally accounts for a minor proportion of the metabolic products. The earliest reported example of P450-mediated hydrocarbon desaturation appears to be the conversion of lindane (1,2,3,4,5,6-hexachloro-cyclohexane) to 1,2,3,4,5,6-hexachlorocyclohex-ene, but the known hydrocarbon desaturation reactions now include the A -desaturation of androstenedione and deoxycorticosterone by adrenal mitochondria, the oxidation of dihydronaphthalene to naphthalene and 7,8-dihydrobenzo[a] pyrene to benzo[a]pyrene the conversion of warfarin to dehydrowarfarin ", the desaturation of lovostatin and simvastatin to the 6-exo-methylene... 

A patient showed a marked increase in his response to acenocoumarol when exposed to insecticides containing ivermectin and methidathion. Another patient was resistant to the effects of warfarin after very heavy exposure to a toxaphene and lindane-containing insecticide. 

The interaction between acenocoumarol and ivermectin with methidathion is not understood. When used on its own, ivermectin used for onchocerciasis normally has no effect on prothrombin times, but two unexplained cases of prolonged prothrombin times associated with the development of haematomas have been reported. Methidathion is an organophosphate. Lindane and other chlorinated hydrocarbon insecticides are known liver enzyme inducers, which increase the metabolism and clearance of the warfarin, thereby reducing or even abolishing its effects. 

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