CMAJ • August 14, 2007; 177 (4). doi:10.1503/cmaj.061284.
© 2007 Canadian Medical Association or its licensors
All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association.
This Article
Right arrow Figures Only
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Résumé
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Hughes, C. A.
Right arrow Articles by Miedzinski, L. J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Hughes, C. A., PharmD
Right arrow Articles by Miedzinski, L. J., MD
Related Collections
Right arrow Adverse drug reactions
Right arrow Français
Right arrowRelated Articles

Research

Case report

Interaction between lopinavir/ritonavir and warfarin

Christine A. Hughes, PharmD, Andrea Freitas, BSc and Lilly J. Miedzinski, MD

From the Faculty of Pharmacy and Pharmaceutical Sciences (Hughes, Freitas), and the Division of Infectious Diseases, Department of Medicine (Miedzinski), University of Alberta; and Capital Health (Hughes), Edmonton, Alta.

Correspondence to: Dr. Christine A. Hughes, Faculty of Pharmacy and Pharmaceutical Sciences, 3126 Dentistry/Pharmacy Centre, University of Alberta, Edmonton AB T6G 2N8; fax 780 492-1217; chughes{at}pharmacy.ualberta.ca

Drug interactions involving protease inhibitors are common. Protease inhibitors are well known inhibitors of the 3A4 isozyme of cytochrome P450. Select protease inhibitors, including co-formulated lopinavir/ritonavir, may induce glucuronidation or the activity of other CYP450 isozymes. We describe the case of a patient taking warfarin who experienced a significantly decreased international normalized ratio after the initiation of antiretroviral therapy that included lopinavir/ritonavir. We review the possible mechanisms of this interaction and the reported interactions between warfarin and other protease inhibitors.


Related Articles

Highlights of this issue
Can. Med. Assoc. J. 2007 177: 325. [Full Text] [PDF]

Dans ce numéro
Can. Med. Assoc. J. 2007 177: 325. [Full Text] [PDF]

Drug–drug interactions between antithrombotic medications and the risk of gastrointestinal bleeding
Joseph A. Delaney, MSc, Lucie Opatrny, MD MSc, James M. Brophy, MD PhD, and Samy Suissa, PhD
Can. Med. Assoc. J. 2007 177: 347-351. [Abstract] [Full Text] [PDF]

Drug interactions with warfarin: what clinicians need to know
David N. Juurlink, MD PhD
Can. Med. Assoc. J. 2007 177: 369-371. [Full Text] [PDF]



This article has been cited by other articles:


Home page
 The Annals of PharmacotherapyHome page
M. D Liedtke and R C. Rathbun
Warfarin-Antiretroviral Interactions
Ann. Pharmacother., February 1, 2009; 43(2): 322 - 328.
[Abstract] [Full Text] [PDF]

Home page
 The Annals of PharmacotherapyHome page
M. M Foisy, E. M Yakiwchuk, and C. A Hughes
Induction Effects of Ritonavir: Implications for Drug Interactions
Ann. Pharmacother., July 1, 2008; 42(7): 1048 - 1059.
[Abstract] [Full Text] [PDF]