1例利福平与华法林相互作用的案例报道及文献分析  

Rifampin and Increase of Warfarin Dose: A Case Report and Review of the Literature

作　　者：孟慧杰[1,2,3] 石伟龙 胡永芳[1,2,3] 

机构地区：[1]北京大学第三医院药剂科,北京100191 [2]北京大学药学院药事管理与临床药学系,北京100191 [3]北京清华长庚医院,北京102218

出　　处：《中国药学杂志》2015年第6期550-553,共4页Chinese Pharmaceutical Journal

基　　金："十二五"国家863计划课题(2012AA02A518)

摘　　要：目的结合实际案例,对利福平与华法林联合使用时华法林剂量的调整进行文献检索和分析,为给药方案的优化提供解决路径。方法报道、分析1例案例,同时查阅相关文献进行综述讨论。结果本例患者在合并使用利福平后,华法林剂量增加至84 mg·week-1时国际标准化比值达标,较黄种人的常规用量21 mg·week-1有明显增加。文献研究提示合并使用利福平时,华法林剂量增加可能达到数倍,停用利福平后,需减少华法林剂量,增加国际标准化比值监测频率。结论华法林与利福平合并使用时,可根据患者国际标准化比值情况增加华法林剂量,基因检测有益于拟定华法林给药方案;停用利福平后,建议增加国际标准化比值监测频率,及时减低华法林剂量,以达到更佳抗凝效果,减少不良反应发生。OBJECTIVE To report an actual case and doing a review about the interaction of warfarin and rifampin to provide a regimen about the combination of the two drugs. METHODS Discribed a case and analyzed it,while access to relevant literature review. RESULTS With concurrent use of rifampin,the dose of warfarin increase to 84 mg· week- 1when targeted INR reached. The available literature suggest that when the two drug concurrent used,warfarin doses may increase for several folds,once discontinue rifampin the warfarin dose should be decreased and more INR tests were needed. CONCLUSION For patient taking rifampin at the same time,the warfarin dose would increase according to the INR,the genetic test may be helpful; when warfarin is discontinued,the warfarin dose may decrease and INR test may increase to get a efficacy and safety anticoagulation therapy.

关 键 词：华法林 利福平 抗凝管理 基因检测 

分 类 号：R969.2[医药卫生—药理学]