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The Annals of Pharmacotherapy: Vol. 26, No. 9, pp. 1084-1086.
© 1992 Harvey Whitney Books Company.
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Research Articles

Enhanced anticoagulant effect of coumarin derivatives induced by doxycycline coadministration

Y Caraco and A Rubinow

OBJECTIVE: To report two cases of enhanced oral anticoagulant effect induced by doxycycline coadministration. DESIGN: Case report. SETTING: University teaching hospital. PATIENTS: Two patients on chronic oral anticoagulation therapy who presented with severe bleeding and marked impairment in blood coagulation tests shortly after the initiation of doxycycline therapy. DISCUSSION: The literature concerning the possible effects of tetracyclines on hemostasis with or without antecedent anticoagulation therapy is reviewed and the speculated mechanisms for such an interaction are discussed. CONCLUSIONS: The administration of tetracyclines such as doxycycline to patients on chronic oral anticoagulation therapy may be associated with a marked enhancement in anticoagulant effect. In such patients the prothrombin ratio should be closely monitored and the anticoagulant dosage adjusted accordingly.


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Copyright © 1992 by Harvey Whitney Books Company.