Moderate
Probable
描述
Hydroxychloroquine may potentiate the anticoagulant effect of warfarin, raising INR and the risk of bleeding complications.
机制
The mechanism is not fully established; proposed mechanisms include inhibition of CYP2C9 and CYP3A4, as well as independent antiplatelet properties of hydroxychloroquine.
临床意义
Several case reports and pharmacovigilance analyses document significant INR elevation and bleeding events when hydroxychloroquine is added to warfarin.
处理措施
Monitor INR frequently when starting hydroxychloroquine in warfarin-treated patients; adjust warfarin dose as needed.