Nutescu Edith A, Shapiro Nancy L, Ibrahim Sonia, West Patricia
Department of Pharmacy Practice, University of Illinois, College of Pharmacy, Chicago, IL 60612, USA.
Expert Opin Drug Saf. 2006 May;5(3):433-51. doi: 10.1517/14740338.5.3.433.
Despite its complex pharmacokinetic and pharmacodynamic profile, warfarin is still one of the most widely used oral anticoagulant agents. Attaining optimal anticoagulation with this agent is clinically challenging in view of its many food and drug interactions. Inappropriate anticoagulation control can expose patients to an increased risk of bleeding or thromboembolic complications, due to over and underanticoagulation, respectively. Fluctuations in dietary vitamin K intake can have a significant effect on the degree of anticoagulation in patients treated with warfarin. In addition, the explosion in use of various dietary supplements and herbal products can lead to undesired outcomes on anticoagulant levels. The aim of this review is to discuss the scope and the potential clinical impact of the most commonly reported food, dietary supplement and herbal interactions with warfarin therapy. Practical steps for patients and providers to minimise these interactions are highlighted.
尽管华法林具有复杂的药代动力学和药效学特征，但它仍是使用最广泛的口服抗凝剂之一。鉴于其存在众多食物和药物相互作用，临床上要实现该药物的最佳抗凝效果具有挑战性。抗凝控制不当会使患者分别因抗凝过度和不足而面临出血或血栓栓塞并发症风险增加的问题。饮食中维生素K摄入量的波动会对华法林治疗患者的抗凝程度产生显著影响。此外，各种膳食补充剂和草药产品使用的激增可能导致抗凝水平出现不良后果。本综述的目的是讨论与华法林治疗最常报道的食物、膳食补充剂和草药相互作用的范围及其潜在临床影响。文中强调了患者和医疗服务提供者将这些相互作用降至最低的实际措施。
