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Successful Anticoagulation With Warfarin After Switching From Rifampin to Rifabutin
PURPOSE: A case of a patient receiving warfarin for pulmonary embolism (PE) concomitantly with rifampin for treatment of active pulmonary tuberculosis (PTB) is presented. A successful clinical intervention whereby the patient achieved therapeutic anticoagulation after switching to an alternative rif...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10521264/ https://www.ncbi.nlm.nih.gov/pubmed/37750044 http://dx.doi.org/10.1177/21501319231197588 |
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author | Alnewais, Marwah E. Landolfa, Samantha L. Bean, Madelyne Fermo, Joli D. |
author_facet | Alnewais, Marwah E. Landolfa, Samantha L. Bean, Madelyne Fermo, Joli D. |
author_sort | Alnewais, Marwah E. |
collection | PubMed |
description | PURPOSE: A case of a patient receiving warfarin for pulmonary embolism (PE) concomitantly with rifampin for treatment of active pulmonary tuberculosis (PTB) is presented. A successful clinical intervention whereby the patient achieved therapeutic anticoagulation after switching to an alternative rifamycin antibacterial, rifabutin, is described. SUMMARY: The drug-drug interaction between warfarin and rifampin is well known and documented. However, to our knowledge, no case reports of the interaction between warfarin and rifabutin have been published, and literature describing this interaction is lacking. We describe the case of a 27-year-old African American female referred to a pharmacist-managed anticoagulation clinic for treatment of PE with warfarin. The patient was also being treated for active tuberculosis with rifampin, isoniazid, pyrazinamide, and ethambutol. Warfarin was initiated and over the course of 1 month was continuously increased to a total weekly dose (TWD) of 140 mg without ever achieving the target international normalized ratio (INR) of 2 to 3. In an attempt to reach the target INR, rifampin was switched to rifabutin to minimize the drug-drug interaction with warfarin. Six days after this switch, the target INR was achieved with a lower warfarin TWD of 115 mg. Rifabutin interacts with warfarin to a lesser degree than rifampin and may be considered as an alternative in patients taking warfarin who require treatment with a rifamycin. CONCLUSION: For patients in whom therapeutic anticoagulation with warfarin has been difficult, the use of rifabutin may be considered in place of rifampin when the concomitant use of a rifamycin is required. |
format | Online Article Text |
id | pubmed-10521264 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-105212642023-09-27 Successful Anticoagulation With Warfarin After Switching From Rifampin to Rifabutin Alnewais, Marwah E. Landolfa, Samantha L. Bean, Madelyne Fermo, Joli D. J Prim Care Community Health Case Studies PURPOSE: A case of a patient receiving warfarin for pulmonary embolism (PE) concomitantly with rifampin for treatment of active pulmonary tuberculosis (PTB) is presented. A successful clinical intervention whereby the patient achieved therapeutic anticoagulation after switching to an alternative rifamycin antibacterial, rifabutin, is described. SUMMARY: The drug-drug interaction between warfarin and rifampin is well known and documented. However, to our knowledge, no case reports of the interaction between warfarin and rifabutin have been published, and literature describing this interaction is lacking. We describe the case of a 27-year-old African American female referred to a pharmacist-managed anticoagulation clinic for treatment of PE with warfarin. The patient was also being treated for active tuberculosis with rifampin, isoniazid, pyrazinamide, and ethambutol. Warfarin was initiated and over the course of 1 month was continuously increased to a total weekly dose (TWD) of 140 mg without ever achieving the target international normalized ratio (INR) of 2 to 3. In an attempt to reach the target INR, rifampin was switched to rifabutin to minimize the drug-drug interaction with warfarin. Six days after this switch, the target INR was achieved with a lower warfarin TWD of 115 mg. Rifabutin interacts with warfarin to a lesser degree than rifampin and may be considered as an alternative in patients taking warfarin who require treatment with a rifamycin. CONCLUSION: For patients in whom therapeutic anticoagulation with warfarin has been difficult, the use of rifabutin may be considered in place of rifampin when the concomitant use of a rifamycin is required. SAGE Publications 2023-09-26 /pmc/articles/PMC10521264/ /pubmed/37750044 http://dx.doi.org/10.1177/21501319231197588 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Case Studies Alnewais, Marwah E. Landolfa, Samantha L. Bean, Madelyne Fermo, Joli D. Successful Anticoagulation With Warfarin After Switching From Rifampin to Rifabutin |
title | Successful Anticoagulation With Warfarin After Switching From Rifampin to Rifabutin |
title_full | Successful Anticoagulation With Warfarin After Switching From Rifampin to Rifabutin |
title_fullStr | Successful Anticoagulation With Warfarin After Switching From Rifampin to Rifabutin |
title_full_unstemmed | Successful Anticoagulation With Warfarin After Switching From Rifampin to Rifabutin |
title_short | Successful Anticoagulation With Warfarin After Switching From Rifampin to Rifabutin |
title_sort | successful anticoagulation with warfarin after switching from rifampin to rifabutin |
topic | Case Studies |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10521264/ https://www.ncbi.nlm.nih.gov/pubmed/37750044 http://dx.doi.org/10.1177/21501319231197588 |
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