Detrimental effects of divalproex on warfarin therapy following mechanical valve replacement

Ashwini Nadkarni; Mark Oldham; Mark Howard; Harold L Lazar; Isidore Berenbaum

doi:10.1111/j.1540-8191.2011.01293.x

Detrimental effects of divalproex on warfarin therapy following mechanical valve replacement

J Card Surg. 2011 Sep;26(5):492-4. doi: 10.1111/j.1540-8191.2011.01293.x. Epub 2011 Aug 22.

Authors

Ashwini Nadkarni¹, Mark Oldham, Mark Howard, Harold L Lazar, Isidore Berenbaum

Affiliation

¹ Department of Psychiatry, The Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts, USA.

PMID: 21859435
DOI: 10.1111/j.1540-8191.2011.01293.x

Abstract

Drug interaction between Warfarin and psychiatric agents may have important therapeutic effects for patients undergoing cardiac surgery. We present a case of a patient in whom concurrent treatment with Warfarin and valproic acid resulted in supratherapeutic international normalized ratio values. A discussion of the possible mechanisms for this interaction as well as a review of interactions between Warfarin and other psychiatric medications is the subject of this case report.

Publication types

Case Reports

MeSH terms

Adult
Anticoagulants / adverse effects
Anticoagulants / therapeutic use
Antimanic Agents / adverse effects
Antimanic Agents / therapeutic use
Bipolar Disorder / complications
Bipolar Disorder / drug therapy*
Drug Interactions
Drug Therapy, Combination
Female
Follow-Up Studies
Heart Valve Prosthesis*
Humans
Mitral Valve Insufficiency / complications
Mitral Valve Insufficiency / diagnosis
Mitral Valve Insufficiency / surgery*
Postoperative Complications / chemically induced*
Thrombosis / prevention & control
Valproic Acid / adverse effects*
Valproic Acid / therapeutic use
Warfarin / adverse effects*
Warfarin / therapeutic use

Substances

Anticoagulants
Antimanic Agents
Warfarin
Valproic Acid