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Paritaprevir/ritonavir/ombitasvir+dasabuvir plus ribavirin therapy and inhibition of the anticoagulant effect of warfarin: a case report
Author(s) -
Puglisi G. M.,
Smith S. M.,
Jankovich R. D.,
Ashby C. R.,
Jodlowski T. Z.
Publication year - 2017
Publication title -
journal of clinical pharmacy and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.622
H-Index - 73
eISSN - 1365-2710
pISSN - 0269-4727
DOI - 10.1111/jcpt.12475
Subject(s) - ombitasvir , dasabuvir , ritonavir , paritaprevir , ribavirin , medicine , warfarin , pharmacology , virology , atrial fibrillation , hepatitis c virus , human immunodeficiency virus (hiv) , virus , viral load , antiretroviral therapy
Summary What is known and objective Paritaprevir/ritonavir/ombitasvir+dasabuvir (Pr OD ) is a direct‐acting antiviral ( DAA ) approved for the treatment of chronic hepatitis C virus. We report on a probable interaction between Pr OD with ribavirin and warfarin. Case description Two weeks after the start of Pr OD with ribavirin, the patient's international normalized ratio ( INR ) became subtherapeutic. Eleven weeks into therapy and following a 125% total increase in the weekly warfarin dose, therapeutic INR was achieved. Thirteen days after DAA therapy was completed and discontinued, the patient's INR became critically supratherapeutic. What is new and conclusion Patients on Pr OD plus ribavirin with warfarin should have INR followed closely upon initiation and discontinuation of therapy due to a probable drug interaction.