Warfarin inhibition in a patient taking complementary and alternative medicine products

Alicia Pence, Philip J. Gregory

Research output: Contribution to journalArticle

Abstract

Objective: To report a case of a decreased international normalized ratio (INR) in a patient taking warfarin in addition to multiple complementary and alternative medicine (CAM) products. Case Summary: A patient on warfarin with a target INR of 2-3 presented to the clinic with an INR of 1.1. Approximately 3 months earlier, the patient had started taking several CAM products, including omega-3 fatty acids, butcher's broom, and hawthorn berry; aloe vera juice was added approximately 6 weeks later. She was not asked to discontinue these products; instead, the warfarin dose was increased to eventually achieve a stable INR of 2.5. Discussion: An objective causality assessment suggests that this interaction was probably related to use of one of the CAMs. However, it is unclear which of these caused the decreased INR. The most likely causative agent was aloe. Conclusions: Patients do not need to discontinue CAM products while taking warfarin. However, these products need to be taken in consistent doses. Any substantial changes in intake of these substances can necessitate a change in anticoagulant therapy.

Original languageEnglish
Pages (from-to)175-177
Number of pages3
JournalJournal of Pharmacy Technology
Volume27
Issue number4
StatePublished - Jul 2011

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Warfarin
Complementary Therapies
International Normalized Ratio
Aloe
Ruscus
Crataegus
Omega-3 Fatty Acids
Causality
Anticoagulants
Fruit

All Science Journal Classification (ASJC) codes

  • Pharmaceutical Science

Cite this

Warfarin inhibition in a patient taking complementary and alternative medicine products. / Pence, Alicia; Gregory, Philip J.

In: Journal of Pharmacy Technology, Vol. 27, No. 4, 07.2011, p. 175-177.

Research output: Contribution to journalArticle

Pence, Alicia ; Gregory, Philip J. / Warfarin inhibition in a patient taking complementary and alternative medicine products. In: Journal of Pharmacy Technology. 2011 ; Vol. 27, No. 4. pp. 175-177.
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