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[Concomitant use of warfarin, analgesics and anti-inflammatory agents] Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række [Tidsskr Nor Laegeforen] Journal article

 
Title[Concomitant use of warfarin, analgesics and anti-inflammatory agents]
Author(s)Håkonsen GD, Pettersen MH, Skurtveit S, Giverhaug T 
InstitutionAvdeling for farmakolog, iInstitutt for farmasi, Universitetet i Tromsø.
SourceTidsskr Nor Laegeforen 2009 Jun 11; 129(12):1217-20.
MeSHAcetaminophen
Aged
Analgesics, Non-Narcotic
Analgesics, Opioid
Anti-Inflammatory Agents, Non-Steroidal
Anticoagulants
Cyclooxygenase Inhibitors
Drug Interactions
Drug Prescriptions
Drug Therapy, Combination
Female
Hemorrhage
Humans
Male
Middle Aged
Norway
Risk Factors
Warfarin
AbstractBACKGROUND: Concomitant use of warfarin and analgesics enhances the risk of bleeding. The frequency of such co-medication has not yet been investigated. The main aim of the present study was to determine the prevalence of concomitant use of warfarin and prescription analgesic drugs in Norway.
MATERIAL AND METHODS: All patients were included who were registered in the Norwegian Prescription Database as having received warfarin (Marevan) at Norwegian pharmacies from 2004 to 2006. Data were retrieved on prescription of warfarin and common analgesic drugs (paracetamol, weak opioids and NSAIDs). "Concomitant medication" was defined as the concurrent use of warfarin and analgesic drugs as prescribed by one or more different physicians at the same or different date, but within the time period for warfarin use.
RESULTS: The number of warfarin users was approximately 80,000 in 2006 (60 % men), 93 % were older than 50 years and the majority were on long-term treatment. 25 % of warfarin patients used weak opioids in each of the following years: 2004, 2005 and 2006, while 16 - 23 % were on NSAIDs and 29 - 31 % on paracetamol.
INTERPRETATION: A higher number of Norwegians is treated with warfarin than previously presumed. Concomitant use of common analgesics was likely for at least one fourth of the warfarin users. As the investigated analgesics may interact with and increase the effect of warfarin (through different mechanisms), the frequent co-prescribing of these drugs may be associated with an increased risk of bleeding.
Languagenor
Pub Type(s)English Abstract
Journal Article
PubMed ID19521444
  
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