Moderate
Probable
説明
Hydroxychloroquine may potentiate the anticoagulant effect of warfarin, raising INR and the risk of bleeding complications.
機序
The mechanism is not fully established; proposed mechanisms include inhibition of CYP2C9 and CYP3A4, as well as independent antiplatelet properties of hydroxychloroquine.
臨床的意義
Several case reports and pharmacovigilance analyses document significant INR elevation and bleeding events when hydroxychloroquine is added to warfarin.
対処法
Monitor INR frequently when starting hydroxychloroquine in warfarin-treated patients; adjust warfarin dose as needed.