Tilstone W J, Gray J M, Nimmo-Smith R H, Lawson D H
Postgrad Med J. 1977 Jul;53(621):388-90. doi: 10.1136/pgmj.53.621.388.
A patient is described in whom there was strong circumstantial evidence of an interaction between warfarin and co-trimaxazole. To test the validity of this hypothesis a series of in vitro and in vivo human studies were untaken. The results indicate that interaction may occur in which the sulphamethoxazole moiety of co-trimoxazole displaces warfarin from its binding sites on plasma albumin. Nevertheless, this interaction occurs only at high plasma levels of warfarin and is most likely to be clinically significant only in patients receiving high doses of warfarin who have low plasma albumin concentrations. These studies indicate that the use of co-trimoxazole is not contra-indicated in patients receiving warfarin therapy, but care should be exercised, especially in patients with high plasma warfarin:albumin ratios.
本文描述了一名患者，有充分的间接证据表明华法林与复方新诺明之间存在相互作用。为了验证这一假设，进行了一系列体外和体内人体研究。结果表明，可能会发生相互作用，即复方新诺明的磺胺甲恶唑部分将华法林从其在血浆白蛋白上的结合位点置换出来。然而，这种相互作用仅在华法林血浆水平较高时发生，并且最有可能仅在接受高剂量华法林且血浆白蛋白浓度较低的患者中具有临床意义。这些研究表明，接受华法林治疗的患者使用复方新诺明并非禁忌，但应谨慎使用，尤其是在血浆华法林与白蛋白比例较高的患者中。
