Fatal drug interaction between cholestyramine and phenprocoumon

We describe a patient with a prosthetic aortic valve who developed fatal valve thrombosis due to an interaction between phenprocoumon and cholestyramine. The general practitioner who had prescribed cholestyramine was aware of a potential interaction between these two drugs and the patient ingested c...

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Bibliographic Details
Published in:European journal of internal medicine 2002-05, Vol.13 (3), p.210-211
Main Authors: Balmelli, Nicola, Dominé, Frédéric, Pfisterer, Matthias, Krähenbühl, Stephan, Marsch, Stephan
Format: Article
Language:English
Subjects:
Anion exchangers
Enterohepatic cycling
Oral anticoagulants
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Summary:We describe a patient with a prosthetic aortic valve who developed fatal valve thrombosis due to an interaction between phenprocoumon and cholestyramine. The general practitioner who had prescribed cholestyramine was aware of a potential interaction between these two drugs and the patient ingested cholestyramine exactly according to the rules of the manufacturer (>1 h before phenprocoumon). However, due to enterohepatic cycling and the long half-life of phenprocoumon, an interaction between these two drugs could not be avoided. We therefore recommend that cholestyramine not be administered to patients treated with drugs undergoing enterohepatic cycling, such as oral anticoagulants.
ISSN:0953-6205
1879-0828
DOI:10.1016/S0953-6205(02)00026-2