Primeaux Brian, Burton Bradley, Shuey Stephanie
1 Division of Pharmacy, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
2 Department of Pharmacy, The Johns Hopkins Hospital, Baltimore, MD, USA.
J Oncol Pharm Pract. 2018 Jan;24(1):74-75. doi: 10.1177/1078155216677853. Epub 2016 Oct 31.
Axitinib is a vascular endothelial growth factor receptor inhibitor indicated for advanced renal cell cancer after failure of one prior systemic therapy. We report a case where a patient receiving axitinib experienced a supratherapeutic INR soon after initiation of an age-appropriate warfarin dose. We propose two possible mechanisms for this interaction, including competitive protein binding and decreased metabolism. Close INR monitoring and dose adjustments of warfarin may be necessary in patients receiving concomitant axitinib and warfarin in order to decrease the risks associated with this interaction.
阿昔替尼是一种血管内皮生长因子受体抑制剂，适用于一线全身治疗失败后的晚期肾细胞癌。我们报告了一例患者，在开始使用适合其年龄的华法林剂量后不久，接受阿昔替尼治疗时国际标准化比值（INR）超过治疗范围。我们提出了这种相互作用的两种可能机制，包括竞争性蛋白结合和代谢减少。对于同时接受阿昔替尼和华法林治疗的患者，可能需要密切监测INR并调整华法林剂量，以降低这种相互作用相关的风险。
