Pornwattanakavee Suphannika, Priksri Watcharapong, Aonkhum Authakorn, Leelakanok Nattawut, Sapapsap Bannawich
Burapha University, Chonburi, Thailand.
Chonburi Hospital, Chonburi, Thailand.
Hosp Pharm. 2024 Jun;59(3):264-271. doi: 10.1177/00185787231214428. Epub 2023 Dec 29.
Initiating favipiravir in COVID-19 patients with long-term warfarin use can lead to increased INR. However, data on the onset and duration of the increasing INR are limited. We reviewed patient charts to include COVID-19 adult patients who received favipiravir for at least 5 days and used warfarin at the same dose for at least 12 weeks. Data on demographics, comorbidities, other medical characteristics, international normalized ratio (INR), and signs of bleeding were collected. Eight patients, with a mean age of 70.88 ± 8.49 years old, received the standard dose of favipiravir. The mean maximum INR (4.30 ± 1.26) was statistically different from the baseline INR ( = .00029) and the change was observed within 4.38 ± 1.99 days after initiating favipiravir. Warfarin was then discontinued without favipiravir discontinuation in most patients, allowing the INR to gradually decrease within 2 to 3 days. Concurrent use of favipiravir and warfarin led to INR prolongation within approximately 4 days. The effect of such interaction can be acute as the prolongation occurred within 1 day in 1 of the patients.
在长期使用华法林的新冠肺炎患者中启用法匹拉韦可导致国际标准化比值（INR）升高。然而，关于INR升高的起始时间和持续时间的数据有限。我们查阅了患者病历，纳入了接受法匹拉韦治疗至少5天且以相同剂量使用华法林至少12周的成年新冠肺炎患者。收集了人口统计学、合并症、其他医学特征、国际标准化比值（INR）和出血迹象的数据。8名平均年龄为70.88±8.49岁的患者接受了标准剂量的法匹拉韦。平均最大INR（4.30±1.26）与基线INR在统计学上有差异（P = 0.00029），且在启用法匹拉韦后4.38±1.99天内观察到了变化。然后在大多数患者中停用了华法林而未停用 法匹拉韦，使INR在2至3天内逐渐下降。法匹拉韦和华法林的同时使用导致INR在约4天内延长。这种相互作用的影响可能是急性的，因为有1名患者在1天内就出现了延长情况。
