Potential Drug-Drug Interactions in Patients Using Warfarin, Heparin, and Enoxaparin abstract
Background:
Drug-drug interactions can often lead to preventable adverse drug events and
hospitalization. However, the clinical outcome of a potential drug-drug interaction that may
range from minor alterations to major toxicity or loss of effect is often unknown. Drugs with
narrow therapeutic index are more susceptible to the outcomes of interactions. Anticoagulants
are one of the drug groups prone to drug-drug interactions and have important side effects. in
this retrospective study, the frequency of drug-drug interactions involving warfarin, heparin and
enoxaparin was investigated.
Methods: Overall, 300 patients (including 55% males with an average age of 50.75 years) participated
in this study, and for each anticoagulant, 100 patient orders were randomly selected from the hospital
system.
Drug-drug interactions were evaluated using the Micromedex drug interaction checker.
Results: A total of 1691 drug-drug interactions (306 major, 253 moderate, and 89 minor interactions)
were recorded of which only 648 (average 2.16) involved warfarin, heparin, or enoxaparin. Most
interactions were recorded in patients admitted to the cardiovascular surgery (n=312) and cardiology
(n=119) wards. There was a significant relationship between the number of drugs and the frequency
of interaction. warfarin had the highest number of interactions (n=388).
Conclusion: The frequency of drug interactions is high in patients on anticoagulant therapy.
The efficacy and safety of these drugs can be affected by drug interactions. Accordingly, these
interactions should always be considered, especially in patients with multiple drug use. Efficient
monitoring strategies should be employed to optimize treatment while reducing adverse effects.