Drug interactions and the risk of serious hemorrhage in patients receiving phenprocoumon
Description
- Vitamin K antagonists (VKAs) have been widely used for more than 50 years for oral anticoagulation and the prevention of venous and arterial thromboembolic diseases. Atrial fibrillation is a common indication, in which the development of thrombs in the atrium is prevented and the risk for stroke gets reduced. Presently about 800.000 patients in Germany receive VKAs, some of them for many years or lifelong. Reduced blood coagulation under treatment with VKAs can lead to serious or life-threatening bleeding. Of particular concern are intracerebral bleedings. In Germany, phenpro-coumon (e.g. Marcumar®) is the most frequently prescribed VKA. For phenprocoumon, various potential interactions are described which can raise or reduce the risk of a bleeding event. Many of them are based on small case series or single cases, so that conclusions for the clinical relevance are not possible.
Whether such interactions are associated with an increased risk of bleeding under a phenprocoumon therapy in Germany, was investigated based on data of the German Pharmacoepidemiological Research Database (GePaRD) using a nested case-control design.
The project was completed in 2011 and the results were published in the European Journal of Clinical Pharmacology. Increased risks were found especially for a combination therapy of phenprocoumon and clopidogrel and for some antibiotics and some non-steroidal anti-inflammatory drugs.
Funding period
- Begin: January 2007
End: December 2011
Sponsor
- BIPS funding
Contact
Selected project-related publications
- Jobski K, Behr S, Garbe E. Drug interactions with phenprocoumon and the risk of serious haemorrhage: A nested case-control study in a large population-based German database. European Journal of Clinical Pharmacology. 2011;67(9):941-951.
https://doi.org/10.1007/s00228-011-1031-6 - Jobski K, Behr S, Garbe E. Drug interactions with phenprocoumon and the risk of serious hemorrhage: A nested case-control study in a large population-based German database. 26th International Conference on Pharmacoepidemiology & Therapeutic Risk Management (ICPE), 19.-22. August 2010, Brighton, United Kingdom.
- Jobski K, Behr S, Garbe E. Drug interactions with phenprocoumon and the risk of serious hemorrhage: A nested case-control study in a large population-based German database. 55. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie (GMDS), 5.-9. September 2010, Mannheim.