Prospective study of the potentiation of acenocoumarol by amiodarone

The influence of oral amiodarone on the anticoagulant effect of the coumarin derivative acenocoumarol has been investigated prospectively in 10 patients with normal renal, hepatic and haematological function and who were not in cardiac failure. The daily dose of acenocoumarol was sufficient to produ...

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Bibliographic Details
Published in:European journal of clinical pharmacology 1985-01, Vol.28 (6), p.625-629
Main Authors: RICHARD, C, RIOU, B, BERDEAUX, A, FOURNIER, C, KHAYAT, D, RIMAILHO, A, GIUDICELLI, J. F, AUZEPY, P
Format: Article
Language:English
Subjects:
Acenocoumarol - pharmacology
Adult
Aged
Amiodarone - blood
Amiodarone - pharmacology
Benzofurans - pharmacology
Biological and medical sciences
Blood Coagulation - drug effects
Blood. Blood coagulation. Reticuloendothelial system
Drug Synergism
Female
Hemodynamics - drug effects
Humans
Male
Medical sciences
Middle Aged
Pharmacology. Drug treatments
Prospective Studies
Prothrombin Time
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Summary:The influence of oral amiodarone on the anticoagulant effect of the coumarin derivative acenocoumarol has been investigated prospectively in 10 patients with normal renal, hepatic and haematological function and who were not in cardiac failure. The daily dose of acenocoumarol was sufficient to produce a prothrombin activity of 25 to 35%. When the prothrombin time had become stable amiodarone 600 mg/d was administered for 1 week followed by 400 mg/d for the next 3 weeks. A decrease in prothrombin activity from 30.5 to 20.2% was observed, associated with a decrease in vitamin K coagulation factors, after a mean of 4 days following commencement of amiodarone. In 6 patients a prothrombin activity less than 20% required a 60% reduction in the dose of acenocoumarol after 1 week of amiodarone 600 mg, and a 33% reduction after 3 weeks of amiodarone 400 mg. There was no correlation between the plasma amiodarone and the decrease in prothrombin activity. Inhibition of acenocoumarol metabolism by amiodarone is the most likely explanation of these findings.
ISSN:0031-6970
1432-1041
DOI:10.1007/BF00607905