Key result
Discontinuation of rifampicin in a patient on warfarin led to a dangerously elevated INR of 11.89 and diffuse alveolar hemorrhage, highlighting the need for frequent INR monitoring.
Case Report (n=1)
Discontinuation of rifampicin in patients on warfarin can lead to a dangerous increase in INR and severe bleeding complications, necessitating frequent INR monitoring.
Supports closer INR monitoring after rifampicin cessation in warfarin patients; remains hypothesis-generating from a single case.
An 83-year-old man under warfarin therapy presented for assessment of prolonged prothrombin time and cough. High-resolution computed tomography findings of the chest showed diffuse alveolar hemorrhage. His international normalized ratio (INR) was 11.89. He had been treated with rifampicin for a persistent infection, but this had been discontinued about two months before admission. Rifampicin suppresses the anticoagulant activity of warfarin, which can lead to a need for increased doses of warfarin to achieve and maintain a therapeutic INR. More frequent INR monitoring is needed even after discontinuing rifampicin.
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Kiyota et al. (2019) conducted a case report in Diffuse alveolar hemorrhage and prolonged prothrombin time (n=1). Rifampicin discontinuation while on warfarin therapy was evaluated on Diffuse alveolar hemorrhage and elevated INR. Discontinuation of rifampicin in a patient on warfarin led to a dangerously elevated INR of 11.89 and diffuse alveolar hemorrhage, highlighting the need for frequent INR monitoring.
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