Fatal haemopericardium and gastrointestinal haemorrhage due to possible interaction of cranberry juice with warfarin

Griffiths, Ann; Beddall, Andrew; Pegler, Scott

doi:10.1177/1466424008096615

Cited by 37 publications

(29 citation statements)

References 11 publications

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“…Recent studies have shown that cranberry juice potently inhibits CYP3A and CYP2C9 in vitro (9, 34); however, in vivo studies with probe substrates for CYP2C9 (S-warfarin), (20). Despite the lack of an effect of cranberry juice on the pharmacokinetics of warfarin (20), several case reports have indicated that cranberry juice results in an enhanced antithrombotic effect of warfarin (8,12,23,27,32,33), suggesting a possible pharmacodynamic effect. A number of studies have reported incidences of apple-, orange-, and grapefruit-drug interactions (6,7,21,29).…”

Section: Discussionmentioning

confidence: 99%

Effects of Cranberry Juice on Pharmacokinetics of β-Lactam Antibiotics following Oral Administration

Li¹,

Andrew

Wang³

et al. 2009

Antimicrob Agents Chemother

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Cranberry juice consumption is often recommended along with low-dose oral antibiotics for prophylaxis for recurrent urinary tract infection (UTI). Because multiple membrane transporters are involved in the intestinal absorption and renal excretion of ␤-lactam antibiotics, we evaluated the potential risk of pharmacokinetic interactions between cranberry juice and the ␤-lactams amoxicillin (amoxicilline) and cefaclor. The amoxicillin-cranberry juice interaction was investigated in 18 healthy women who received on four separate occasions a single oral test dose of amoxicillin at 500 mg and 2 g with or without cranberry juice cocktail (8 oz) according to a crossover design. A parallel cefaclor-cranberry juice interaction study was also conducted in which 500 mg cefaclor was administered with or without cranberry juice cocktail (12 oz). Data were analyzed by noncompartmental methods and nonlinear mixed-effects compartmental modeling. We conclude that the concurrent use of cranberry juice has no significant effect on the extent of oral absorption or the renal clearance of amoxicillin and cefaclor. However, delays in the absorption of amoxicillin and cefaclor were observed. These results suggest that the use of cranberry juice at usual quantities as prophylaxis for UTI is not likely to alter the pharmacokinetics of these two oral antibiotics.

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Section: Discussionmentioning

confidence: 99%

Effects of Cranberry Juice on Pharmacokinetics of β-Lactam Antibiotics following Oral Administration

Li¹,

Andrew

Wang³

et al. 2009

Antimicrob Agents Chemother

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“…[26][27][28][29][30] Cranberry juice is a flavonoid, which has been shown to induce, inhibit, or act as a substrate for the biosynthesis of several cytochrome P-450 (CYP) isoenzymes. Specifically, cranberry juice may inhibit the activity of CYP2C9, the primary isoenzyme involved in the metabolism of S-warfarin.…”

Section: Warfarinmentioning

confidence: 99%

Food Drug Interactions

Bushra¹,

Aslam²,

Khan³

2011

OMJ

218

147

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The effect of drug on a person may be different than expected because that drug interacts with another drug the person is taking (drug-drug interaction), food, beverages, dietary supplements the person is consuming (drug-nutrient/food interaction) or another disease the person has (drug-disease interaction). A drug interaction is a situation in which a substance affects the activity of a drug, i.e. the effects are increased or decreased, or they produce a new effect that neither produces on its own. These interactions may occur out of accidental misuse or due to lack of knowledge about the active ingredients involved in the relevant substances. Regarding food-drug interactions physicians and pharmacists recognize that some foods and drugs, when taken simultaneously, can alter the body's ability to utilize a particular food or drug, or cause serious side effects. Clinically significant drug interactions, which pose potential harm to the patient, may result from changes in pharmaceutical, pharmacokinetic, or pharmacodynamic properties. Some may be taken advantage of, to the benefit of patients, but more commonly drug interactions result in adverse drug events. Therefore it is advisable for patients to follow the physician and doctors instructions to obtain maximum benefits with least food-drug interactions. The literature survey was conducted by extracting data from different review and original articles on general or specific drug interactions with food. This review gives information about various interactions between different foods and drugs and will help physicians and pharmacists prescribe drugs cautiously with only suitable food supplement to get maximum benefit for the patient.

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“…On the basis of multiple published cases (including 2 cases of fatal interaction) reporting increased international normalized ratio (INR) and haemorrhage [21,22,23,24,25,26,27,28,29,30,31], serious concerns have been raised regarding a possible interaction with the anticoagulant warfarin. However, these warnings may possibly be attributed to misleading conclusions [32].…”

Section: Clinical Interactions Between Herbs and Conventional Drugsmentioning

confidence: 99%

Interactions between Herbs and Conventional Drugs: Overview of the Clinical Data

2012

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This article provides an overview of the clinical evidence of interactions between herbal and conventional medicines. Herbs involved in drug interactions – or that have been evaluated in pharmacokinetic trials – are discussed in this review. While many of the interactions reported are of limited clinical significance and many herbal products (e.g. black cohosh, saw palmetto, echinacea, hawthorn and valerian) seem to expose patients to minor risk under conventional pharmacotherapy, a few herbs, notably St. John’s wort, may provoke adverse events sufficiently serious to endanger the patients’ health. Healthcare professionals should remain vigilant for potential interactions between herbal medicines and prescribed drugs, especially when drugs with a narrow therapeutic index are used.

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Fatal haemopericardium and gastrointestinal haemorrhage due to possible interaction of cranberry juice with warfarin

Cited by 37 publications

References 11 publications

Effects of Cranberry Juice on Pharmacokinetics of β-Lactam Antibiotics following Oral Administration

Effects of Cranberry Juice on Pharmacokinetics of β-Lactam Antibiotics following Oral Administration

Food Drug Interactions

Interactions between Herbs and Conventional Drugs: Overview of the Clinical Data

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