Overanticoagulation associated with combined use of lactulose and coumarin anticoagulants.
SourceBritish Journal of Clinical Pharmacology, 57, 4, (2004), pp. 522-524
Article / Letter to editor
Display more detailsDisplay less details
Epidemiology, Biostatistics & HTA
British Journal of Clinical Pharmacology
SubjectEBP 4: Quality of Care
Some medical textbooks on drug interactions take note of the potential interaction between laxatives and coumarin anticoagulants, but epidemiological evidence that this interaction is of practical importance is lacking. We conducted a follow-up study in a large population-based cohort to investigate which laxatives are associated with overanticoagulation during therapy with coumarins. Of the 1124 patients in the cohort, 351 developed an International Normalized Ratio > or = 6.0. The only laxative with a moderate but significantly increased relative risk of overanticoagulation was lactulose (relative risk 3.4, 95% confidence interval 2.2, 5.3). In view of the widespread use of lactulose, especially among the elderly, awareness of this potential drug interaction is required.
Upload full text