著者

和田 恭一 保田 智恵子 花房 小百合 高田 充隆 柴川 雅彦

出版者

一般社団法人日本医療薬学会

雑誌

医療薬学 (ISSN:1346342X)

巻号頁・発行日

vol.28, no.5, pp.468-472, 2002-10-10 (Released:2011-03-04)

参考文献数

9

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Fluvoxamine, a selective serotonin reuptake inhibitor (SSRI), is widely used in the treatment of patients with depression. It is known that fluvoxamine inhibits the activity of human cytochrome P450 enzymes (CYP) responsible for the oxidative metabolism of many drugs. Inhibition of CYP results in a number of clinically important pharmacokinetic drug interactions.Therefore, the interaction between warfarin and fluvoxamine was evaluated. The patients treated with fluvoxamine were selected from the prescription database file made for the prescriptions order entry system, which contains all the prescriptions filled for the inpatients and outpatients. There were 106 patients treated with fluvoxamine between July 2000 and June 2001. Of 106 patients, 20 used warfarin concomitantly during the study period. Increased INR/Dose values were observed in all patients after the initiation of fluvoxamine therapy. Subsequently, the high INR/Dose values were observed during the concomitant use of warfarin and fluvoxamine (P<0.01). It is suggested that the increase in the anticoagulant activity of warfarin occurred when fluvoxamine is used concomitantly. Therefore, frequent coagulation tests are required in patients treated with warfarin after the initiation or discontinuation of fluvoxamine therapy. In conclusion, warfarin should be used with worry when fluvoxamine is used concomitantly.