Ascorbic acid-induced warfarin resistance after breast cancer surgery: a case report and literature review

被引：0

作者：

Gao, Pingfa ^{[1
]}

Shen, Yang ^{[2
]}

Wu, Ping ^{[3
]}

Lv, Wenjie ^{[1
,3
]}

机构：

[1] Shanghai Univ Med & Hlth Sci, Chongming Hosp, Dept Thyroid & Breast Surg, Shanghai, Peoples R China

[2] Shanghai Univ Med & Hlth Sci, Shanghai, Peoples R China

[3] Shanghai Jiao Tong Univ, Xinhua Hosp, Dept Breast Surg, Sch Med, Shanghai, Peoples R China

来源：

FRONTIERS IN PHARMACOLOGY | 2024年 / 15卷

关键词：

ascorbic acid; warfarin resistance; pharmacokinetics; pharmacodynamics; case reports; DRUG-INTERACTION; HEREDITARY RESISTANCE; VITAMIN-C; ANTICOAGULATION; MECHANISM; PHARMACOLOGY; MANAGEMENT; RIFAMPIN;

D O I：

10.3389/fphar.2024.1390996

中图分类号：

R9 [药学];

学科分类号：

1007 ;

摘要：

Warfarin is an anticoagulant that requires INR-based dosage adjustment. Ascorbic acid may impair warfarin effectiveness according to limited literature. We report a rare case of a 63-year-old woman with an aortic valve replacement history who developed warfarin resistance after taking ascorbic acid for anemia following breast cancer surgery. Despite increasing the warfarin dose from 6 mg to 10 mg daily, her INR remained below the therapeutic range. After ruling out other causes of warfarin resistance, we discontinued ascorbic acid and observed a rapid increase in INR to target values. The temporal relationship and the absence of other confounding factors confirmed the causality of ascorbic acid in this case. We recommend that patients concomitantly taking vitamin C and warfarin should monitor their INR values closely and discontinue ascorbic acid as soon as possible if they exhibit signs of warfarin resistance.

引用

页数：7

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