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Research Articles |
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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 A. K. Shetty Tetracyclines in Pediatrics Revisited Clinical Pediatrics, May 1, 2002; 41(4): 203 - 209. [PDF]
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 A. M. Baciewicz and B. S. Bal Bleeding Associated With Doxycycline and Warfarin Treatment Arch Intern Med, May 14, 2001; 161(9): 1231 - 1231. [Full Text] [PDF]
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N. Joshi and D. Q. Miller Doxycycline Revisited Arch Intern Med, July 14, 1997; 157(13): 1421 - 1428. [Abstract] [PDF]
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