Zhang Xi, Jiao Fengwei, Li Guangrun, Yu Xiaojia, Pei Yuqing, Zhang Ying, Wang Zihui, Li Pengfei
Department of Pharmacy, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
Front Pharmacol. 2023 May 19;14:1191608. doi: 10.3389/fphar.2023.1191608. eCollection 2023.
Azvudine (FNC) is a promising treatment candidate for managing coronavirus disease 2019 (COVID-19). However, drug interactions with azvudine have been poorly studied, especially with no reported cases of azvudine with anticoagulants such as warfarin and rivaroxaban. The patient was diagnosed with lower limb venous thrombosis and took warfarin regularly. The international normalized ratio (INR) was stable (2.0-3.0). However, the INR increased to 7.52 after administering azvudine. The patient had no other factors justifying this change. This increase in INR occurred again with the administration of azvudine in combination with rivaroxaban, and the INR increased to 18.91. After azvudine administration was stopped, the INR did not increase when rivaroxaban was used alone. Azvudine, warfarin, and rivaroxaban might have previously unidentified drug interactions that increased the INR. Therefore, the INR must be closely monitored when they are concomitantly administered in COVID-19 patients.
阿兹夫定（FNC）是治疗2019冠状病毒病（COVID-19）的一种有前景的候选药物。然而，与阿兹夫定的药物相互作用研究较少，尤其是尚无阿兹夫定与华法林和利伐沙班等抗凝剂相互作用的病例报道。该患者被诊断为下肢静脉血栓形成并定期服用华法林。国际标准化比值（INR）稳定（2.0 - 3.0）。然而，服用阿兹夫定后INR升至7.52。患者没有其他因素可以解释这一变化。在阿兹夫定与利伐沙班联合使用时，INR再次升高，升至18.91。停用阿兹夫定后，单独使用利伐沙班时INR未升高。阿兹夫定、华法林和利伐沙班可能存在此前未被发现的药物相互作用，从而导致INR升高。因此，在COVID-19患者同时使用这些药物时，必须密切监测INR。
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