Key result
Discontinuation of carbamazepine in a patient receiving warfarin led to extreme elevation of prothrombin time and clinically significant hemorrhage due to delayed warfarin excretion.
Why the study?
Does discontinuation of carbamazepine in a patient on warfarin cause clinically significant hemorrhage?
Case Report (n=1)
Does discontinuation of carbamazepine in a patient on warfarin cause clinically significant hemorrhage?
Discontinuation of carbamazepine in patients taking warfarin can lead to excessive hypoprothrombinemia and clinically significant hemorrhage due to a drug interaction.
Clinicians should monitor INR after carbamazepine discontinuation in warfarin users; leaves open the interaction's frequency and optimal management.
A 61-year-old woman receiving warfarin for postoperative atrial fibrillation and carbamazepine for a peripheral neuropathy had extreme elevation of prothrombin time associated with clinically significant hemorrhage when the carbamazepine therapy was discontinued. The mechanism of this significant drug interaction involves the withdrawal of carbamazepine-induced enhancement of hepatic warfarin breakdown with resultant delay of warfarin excretion and excessive hypoprothrombinemia. The clinically significant hemorrhage associated with warfarin-carbamazepine interaction is an indication for caution when these two agents are prescribed concomitantly.
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DENBOW et al. (1990) conducted a case report in Postoperative atrial fibrillation and peripheral neuropathy (n=1). Discontinuation of carbamazepine therapy while on warfarin was evaluated on Extreme elevation of prothrombin time and clinically significant hemorrhage. Discontinuation of carbamazepine in a patient receiving warfarin led to extreme elevation of prothrombin time and clinically significant hemorrhage due to delayed warfarin excretion.