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Erschienen in: Clinical Rheumatology 4/2021

10.08.2020 | Case Based Review

Pickles and warfarin interaction: a case-based review

verfasst von: Alexa Rangecroft, Shamit S. Prabhu, Chi-Cheng Huang

Erschienen in: Clinical Rheumatology | Ausgabe 4/2021

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Abstract

A 36-year-old woman with a history of lupus and antiphospholipid syndrome controlled by warfarin presented to the hospital with left periorbital ecchymosis. She was found to have an INR of 9 despite maintaining her normal warfarin dose of 12.5 mg/15 mg alternating qd. The only identifiable precipitating factor was that the patient recently stopped eating dill pickles. Limiting dietary vitamin K while on warfarin therapy was once considered best practice. However, studies have demonstrated that maintaining a consistent intake of vitamin K is more important than the quantity. Still, many patients on warfarin remain unaware of which foods contain large amounts of vitamin K and are, therefore, susceptible to bleeding sequelae. Practitioners should be educated to inform patients to consume a steady amount of vitamin K in their diet, identify which foods contain vitamin K, and include pickles on that list.
Literatur
1.
Zurück zum Zitat Holbrook AM, Pereira JA, Labiris R, McDonald H, Douketis JD, Crowther M, Wells PS (2005) Systematic overview of warfarin and its drug and food interactions. Arch Intern Med 165(10):1095–1106CrossRef Holbrook AM, Pereira JA, Labiris R, McDonald H, Douketis JD, Crowther M, Wells PS (2005) Systematic overview of warfarin and its drug and food interactions. Arch Intern Med 165(10):1095–1106CrossRef
2.
Zurück zum Zitat Hirsh J, Fuster V, Ansell J, Halperin JL, American Heart Association/American College of Cardiology Foundation (2003) American Heart Association/American College of Cardiology Foundation guide to warfarin therapy. J Am Coll Cardiol 41(9):1633–1652CrossRef Hirsh J, Fuster V, Ansell J, Halperin JL, American Heart Association/American College of Cardiology Foundation (2003) American Heart Association/American College of Cardiology Foundation guide to warfarin therapy. J Am Coll Cardiol 41(9):1633–1652CrossRef
3.
Zurück zum Zitat Franco V, Polanczyk CA, Clausell N, Rohde LE (2004) Role of dietary vitamin K intake in chronic oral anticoagulation: prospective evidence from observational and randomized protocols. Am J Med 116(10):651–656CrossRef Franco V, Polanczyk CA, Clausell N, Rohde LE (2004) Role of dietary vitamin K intake in chronic oral anticoagulation: prospective evidence from observational and randomized protocols. Am J Med 116(10):651–656CrossRef
4.
Zurück zum Zitat Hirsh J et al (2001) Oral anticoagulants: mechanism of action clinical effectiveness and optimal therapeutic range. Chest 119(suppl 1):8S–21SCrossRef Hirsh J et al (2001) Oral anticoagulants: mechanism of action clinical effectiveness and optimal therapeutic range. Chest 119(suppl 1):8S–21SCrossRef
5.
Zurück zum Zitat Norwood DA, Parke CK, Rappa LR (2015) A comprehensive review of potential warfarin-fruit interactions. J Pharm Pract 28(6):561–571CrossRef Norwood DA, Parke CK, Rappa LR (2015) A comprehensive review of potential warfarin-fruit interactions. J Pharm Pract 28(6):561–571CrossRef
6.
Zurück zum Zitat Couris RR, Tataronis GR, Dallal GE, Blumberg JB, Dwyer JT (2000) Assessment of healthcare professionals’ knowledge about warfarin-vitamin K drug-nutrient interactions. J Am Coll Nutr 19(4):439–445CrossRef Couris RR, Tataronis GR, Dallal GE, Blumberg JB, Dwyer JT (2000) Assessment of healthcare professionals’ knowledge about warfarin-vitamin K drug-nutrient interactions. J Am Coll Nutr 19(4):439–445CrossRef
8.
Zurück zum Zitat Kahlon P, Nabi S, Arshad A, Jabbar A, Haythem A (2016) Warfarin dosing and time required to reach therapeutic international normalized ratio in patients with Hypercoaguable conditions. Turk J Haematol 33(4):299–303CrossRef Kahlon P, Nabi S, Arshad A, Jabbar A, Haythem A (2016) Warfarin dosing and time required to reach therapeutic international normalized ratio in patients with Hypercoaguable conditions. Turk J Haematol 33(4):299–303CrossRef
9.
Zurück zum Zitat Kremers RMW, Zuily S, Kelchtermans H, Peters TC, Bloemen S, Regnault V, Hemker HC, de Groot PG, Wahl D, de Laat B (2018) Prothrombin conversion is accelerated in the antiphospholipid syndrome and insensitive to thrombomodulin. Blood Adv 2(11):1315–1324CrossRef Kremers RMW, Zuily S, Kelchtermans H, Peters TC, Bloemen S, Regnault V, Hemker HC, de Groot PG, Wahl D, de Laat B (2018) Prothrombin conversion is accelerated in the antiphospholipid syndrome and insensitive to thrombomodulin. Blood Adv 2(11):1315–1324CrossRef
10.
Zurück zum Zitat Ames PR et al (2011) Increased warfarin consumption and residual fibrin turnover in thrombotic patients with primary antiphospholipid syndrome. Thromb Res 127(6):595–599CrossRef Ames PR et al (2011) Increased warfarin consumption and residual fibrin turnover in thrombotic patients with primary antiphospholipid syndrome. Thromb Res 127(6):595–599CrossRef
11.
Zurück zum Zitat Violi F et al (2016) Interaction between dietary vitamin K intake and anticoagulation by vitamin K antagonists: is it really true?: a systematic review. Medicine (Baltimore) 95(10):e2895CrossRef Violi F et al (2016) Interaction between dietary vitamin K intake and anticoagulation by vitamin K antagonists: is it really true?: a systematic review. Medicine (Baltimore) 95(10):e2895CrossRef
12.
Zurück zum Zitat LeBlanc C et al (2016) Avoidance of vitamin K-rich goods is common among warfarin users and translates into lower usual vitamin K intakes. J Acad Nutr Diet 116(6):1000–1007CrossRef LeBlanc C et al (2016) Avoidance of vitamin K-rich goods is common among warfarin users and translates into lower usual vitamin K intakes. J Acad Nutr Diet 116(6):1000–1007CrossRef
Metadaten
Titel
Pickles and warfarin interaction: a case-based review
verfasst von
Alexa Rangecroft
Shamit S. Prabhu
Chi-Cheng Huang
Publikationsdatum
10.08.2020
Verlag
Springer International Publishing
Erschienen in
Clinical Rheumatology / Ausgabe 4/2021
Print ISSN: 0770-3198
Elektronische ISSN: 1434-9949
DOI
https://doi.org/10.1007/s10067-020-05324-9

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