Key result
Omeprazole use in patients receiving long-term acenocoumarol did not alter the need for anticoagulant dose adaptation, with 62.7% of omeprazole users and 56.5% of controls requiring no dose change.
Why the study?
Does omeprazole alter the required dose of acenocoumarol in patients on long-term oral anticoagulant therapy?
Cohort (n=417)
Does omeprazole alter the required dose of acenocoumarol in patients on long-term oral anticoagulant therapy?
Absolute Event Rate: 62.7% vs 56.5%
Omeprazole can be safely administered to patients treated with acenocoumarol without requiring routine anticoagulant dose adjustments.
Supports omeprazole co-use without acenocoumarol dose changes in observational data; leaves open randomized confirmation of no interaction.
BACKGROUND: Omeprazole is eliminated almost completely by hepatic metabolism within the cytochrome P-450 system and might inhibit the oxidative metabolism of other drugs. This is particularly relevant for compounds with a narrow therapeutic range, such as acenocoumarol. In this study we evaluated the effect of omeprazole use in patients receiving continuous acenocoumarol therapy. METHODS: One thousand and fifty-seven patients receiving long-term oral acenocoumarol combined with omeprazole were selected retrospectively. In 118 of these patients omeprazole was considered the only factor of possible influence on anticoagulant therapy. The control group consisted of 299 age- and sex-matched patients taking acenocoumarol without interfering medication. Dose adjustment of acenocoumarol on starting omeprazole therapy was indicated by clinically relevant changes in coagulation time. RESULTS: No adaptation of the anticoagulant dose was necessary in 74 of 118 omeprazole patients (62.7%), compared with 169 of 299 controls (56.5%). A higher dose was necessary in 30 of 118 omeprazole patients (25.4%), compared with 84 of 299 controls (28.0%). In 14 of 118 omeprazole patients (11.9%) a lowering of the anticoagulant dose was required, compared with 46 of 299 controls (15.4%). CONCLUSIONS: We found no evidence of any interaction between omeprazole and acenocoumarol. It seems likely that omeprazole can be administered safely to patients treated with acenocoumarol.
No takes yet. Share an insight, caveat, or question.
Vreeburg et al. (1997) conducted a cohort in Patients receiving continuous acenocoumarol therapy (n=417). Omeprazole vs. Acenocoumarol without interfering medication was evaluated on No adaptation of the anticoagulant dose. Omeprazole use in patients receiving long-term acenocoumarol did not alter the need for anticoagulant dose adaptation, with 62.7% of omeprazole users and 56.5% of controls requiring no dose change.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: