Hu YN, Zhou BT, Yang HR, Peng QL, Gu XR, Sun SS. Effect of rifampicin on anticoagulation of warfarin: A case report. World J Clin Cases 2021; 9(5): 1087-1095 [PMID: 33644171 DOI: 10.12998/wjcc.v9.i5.1087]
Corresponding Author of This Article
Bo-Ting Zhou, MD, PhD, Chief Pharmacist, Professor, Department of Pharmacy, Xiangya Hospital, Central South University, No. 87 Xiangya Road, Kaifu District, Changsha 410008, Hunan Province, China. botingzhou0918@126.com
Research Domain of This Article
Pharmacology & Pharmacy
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Ya-Ni Hu, Bo-Ting Zhou, Hua-Rong Yang, Qi-Lin Peng, Xu-Rui Gu, Department of Pharmacy, Xiangya Hospital, Central South University, Changsha 410008, Hunan Province, China
Bo-Ting Zhou, The Institute of Hospital Pharmacy, Central South University, Changsha 410008, Hunan Province, China
Shu-Sen Sun, College of Pharmacy and Health Sciences, Western New England University, Springfield, MA 31329, United States
Author contributions: Hu YN and Zhou BT were the patient’s pharmacists; Hu YN reviewed the literature and contributed to manuscript drafting; Hu YN, Zhou BT, Yang HR, Peng QL and Gu XR integrated the information from the patient and contributed to the figure; Zhou BT and Sun SS were responsible for revision of the manuscript; the major reviewing and editing were completed by Zhou BT and Hu YN; All authors commented on previous versions of the manuscript and issued final approval for the version to be submitted.
Informed consent statement: The patient agreed to treatment throughout and shared the information through this paper.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Bo-Ting Zhou, MD, PhD, Chief Pharmacist, Professor, Department of Pharmacy, Xiangya Hospital, Central South University, No. 87 Xiangya Road, Kaifu District, Changsha 410008, Hunan Province, China. botingzhou0918@126.com
Received: June 9, 2020 Peer-review started: June 9, 2020 First decision: November 30, 2020 Revised: December 22, 2020 Accepted: December 28, 2020 Article in press: December 28, 2020 Published online: February 16, 2021 Processing time: 235 Days and 8.1 Hours
Abstract
BACKGROUND
The drug interaction between warfarin and rifampicin is widely known, but there are still some difficulties in managing the combination of the two drugs.
CASE SUMMARY
A patient with brucellosis received strict monitoring from a Chinese pharmacist team during combination of warfarin and rifampicin. The dose of warfarin was increased to 350% in 3 mo before reaching the lower international normalized ratio treatment window. No obvious adverse reaction occurred during the drug-adjustment period. This is the first case report of long-term combined use of rifampicin and warfarin in patients with brucellosis and valve replacement in China based on the Chinese lower warfarin dose and international normalized ratio range.
CONCLUSION
Anticoagulation for valve replacement in Chinese patients differs from that in other races. Establishment of a pharmacist clinic provides vital assistance in warfarin dose adjustment.
Core Tip: Brucellosis is a zoonotic disease with increasing incidence. In order to improve the adherence and cure rate of outpatients, doxorubicin and rifampicin is the preferred treatment. We described a patient with brucellosis and mechanical valve replacement caused by infective endocarditis who required the combination of rifampicin and warfarin. The case highlighted the racial differences in the therapeutic range of the international normalized ratio and the adjustment range of warfarin dose. Individualized medication is required. Pharmacists can help reduce the burden on doctors and the risk of adverse reactions.
