Enhancement of Anticoagulant Effect of Warfarin by Benzbromarone, an Uricosuric Drug

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  • KUDO Tatsuhiko
    Department of Cardiovascular Surgery. Hachioji Medical Center of Tokyo Medical College
  • SUDO Hiroshi
    Department of Cardiovascular Surgery. Hachioji Medical Center of Tokyo Medical College

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  • 痛風治療薬 benzbromarone の warfarin に対する相互作用の検討

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Abstract

Recently a rapid decline of thrombotest values in several patients on warfarin therapy with benzbromarone was observed. Since conbination therapy with benzbromarone appeared to give rise to a bleeding tendency, both drugs were investigated for interactions.<br>The study subjects included 8 patients who had been treated with warfarin for cardiovascular disease and were also given benzbromarone for gout. The doses of warfarin averaged 1.94mg, with a range of 1.0 to 3.0mg/day, and the average dose of benzbromarone was 62.5mg, with a range of 50 to 100mg/day. While keeping the patients on warfarin therapy, benzbromarone was withdrawn for one week only, and changes in the blood coagulation systems were determined before and after withdrawal of benzbromarone.<br>The mean thrombotest value was increased from 22.3% (PT-INR 2.0) to 43.0% (1.4) after drug withdrawal, coagulation factor II increased from 57.3% to 74.5%, PIVKA-II decreased from 11.5AU/ml to 7.0 AU/ml, and the blood concentration of warfarin decreased from 656.5ng/ml to 563.6ng/ml. All the changes were statistically significant (p<0.05). These results indicate that benzbromarone strongly potentiates warfarin. When both drugs are to be combined clinically, patients should be carefully observed for a bleeding tendency.

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