Bell W R, Anderson K C, Noe D A, Silver B A
Arch Intern Med. 1986 Dec;146(12):2325-8.
The interaction between the histamine H-2 receptor antagonist, cimetidine, and warfarin sodium was prospectively studied in 14 patients who were previously anticoagulated for five years. The patients received warfarin and cimetidine concomitantly for a minimum of ten days. Seven of the patients experienced increases in plasma warfarin concentrations. This correspondingly resulted in abnormal prolongation of their prothrombin times. In these patients the elevation in the steady-state warfarin concentration demonstrates that coadministration of cimetidine significantly reduces the plasma clearance rate of warfarin. The serum and urine metabolite levels of warfarin were not qualitatively different in the absence in contrast to the presence of cimetidine. It is apparent that cimetidine can act as an inhibitory influence on the catabolic degradation of warfarin.
对14名先前已接受抗凝治疗五年的患者进行了前瞻性研究，以探讨组胺H-2受体拮抗剂西咪替丁与华法林钠之间的相互作用。患者同时接受华法林和西咪替丁治疗至少10天。7名患者的血浆华法林浓度升高。这相应地导致他们的凝血酶原时间异常延长。在这些患者中，稳态华法林浓度的升高表明，西咪替丁的共同给药显著降低了华法林的血浆清除率。与存在西咪替丁的情况相比，在不存在西咪替丁的情况下，华法林的血清和尿液代谢物水平在质量上没有差异。显然，西咪替丁可对华法林的分解代谢产生抑制作用。
