Richard C, Riou B, Berdeaux A, Fournier C, Khayat D, Rimailho A, Giudicelli J F, Auzépy P
Eur J Clin Pharmacol. 1985;28(6):625-9. doi: 10.1007/BF00607905.
The influence of oral amiodarone on the anticoagulant effect of the coumarin derivative acenocoumarol has been investigated prospectively in 10 patients with normal renal, hepatic and haematological function and who were not in cardiac failure. The daily dose of acenocoumarol was sufficient to produce a prothrombin activity of 25 to 35%. When the prothrombin time had become stable amiodarone 600 mg/d was administered for 1 week followed by 400 mg/d for the next 3 weeks. A decrease in prothrombin activity from 30.5 to 20.2% was observed, associated with a decrease in vitamin K coagulation factors, after a mean of 4 days following commencement of amiodarone. In 6 patients a prothrombin activity less than 20% required a 60% reduction in the dose of acenocoumarol after 1 week of amiodarone 600 mg, and a 33% reduction after 3 weeks of amiodarone 400 mg. There was no correlation between the plasma amiodarone and the decrease in prothrombin activity. Inhibition of acenocoumarol metabolism by amiodarone is the most likely explanation of these findings.
对10名肾功能、肝功能和血液学功能正常且无心力衰竭的患者进行了前瞻性研究，以探讨口服胺碘酮对香豆素衍生物醋硝香豆素抗凝作用的影响。醋硝香豆素的日剂量足以使凝血酶原活性达到25%至35%。当凝血酶原时间稳定后，给予胺碘酮600mg/d，持续1周，随后400mg/d，持续3周。胺碘酮开始使用后平均4天，观察到凝血酶原活性从30.5%降至20.2%，同时维生素K凝血因子减少。在6名患者中，胺碘酮600mg使用1周后，凝血酶原活性低于20%，需要将醋硝香豆素剂量减少60%；胺碘酮400mg使用3周后，需要将醋硝香豆素剂量减少33%。血浆胺碘酮水平与凝血酶原活性降低之间无相关性。胺碘酮抑制醋硝香豆素代谢最有可能解释这些发现。
