{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T13:29:50Z","timestamp":1773235790279,"version":"3.50.1"},"reference-count":6,"publisher":"Oxford University Press (OUP)","issue":"890","license":[{"start":{"date-parts":[[1999,12,1]],"date-time":"1999-12-01T00:00:00Z","timestamp":944006400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[1999,12,1]]},"abstract":"<jats:title>Summary<\/jats:title>\n               <jats:p>Acid-suppressing drugs and anticoagulants are used increasingly in general practice. Warfarin is potentiated by some acid-suppressing drugs, notably cimetidine and omeprazole, through interference of the cytochrome P450 system. This study aimed to ascertain the extent of co-prescribing of warfarin and acid-suppressing drugs in general practice. We conducted a retrospective survey of the records of all patients prescribed acid-suppressing drugs over a 2-year period to ascertain those who had also taken warfarin; we also made a cross-sectional survey of all patients on warfarin to ascertain those who had taken acid-suppressing drugs. From a general practice population of 45 574 patients in northern England, 3423 (7.5%) had been prescribed acid-suppressing drugs during the previous 24 months. Of 274 patients who had been on warfarin, 44 (16.1%) had also taken acid-suppressing drugs (26 H2 receptor blockers and 18 proton-pump inhibitors). The commonest reasons for anticoagulation were thrombo-embolic disease (40.9%), atrial fibrillation (36.4%), valvular heart disease (18.2%), and surgical prophylaxis (4.5%). The indications for concurrent acid-suppressing drugs were: \u2018dyspepsia\u2019 38.6%, reflux 22.7%, oesophagitis 13.6%, duodenal ulcer 13.6%, gastric ulcer 4.5%, unknown 6.8%. There have been no studies from primary care to evaluate the possible clinical effects of the concomitant use of acid-suppressing drugs and warfarin; some fluctuations in coagulation control, particularly in patients taking the combinations intermittently, may be due to this.<\/jats:p>","DOI":"10.1136\/pgmj.75.890.721","type":"journal-article","created":{"date-parts":[[2015,2,18]],"date-time":"2015-02-18T00:04:10Z","timestamp":1424217850000},"page":"721-722","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Co-prescription of H2 receptor blockers and proton pump inhibitors with warfarin in general practice"],"prefix":"10.1093","volume":"75","author":[{"given":"A Pali S","family":"Hungin","sequence":"first","affiliation":[{"name":"Centre for Health Studies, Elvet Riverside, University of Durham , Durham DH1 3JT, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Greg P","family":"Rubin","sequence":"additional","affiliation":[{"name":"Department of Primary Health Care, The Medical School, University of Newcastle upon Tyne , NE2, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hilda","family":"O'Flanagan","sequence":"additional","affiliation":[{"name":"The Health Centre , Eaglescliffe, Stockton on Tees TS16 9EA, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[1999,12,1]]},"reference":[{"key":"2023050812335220000_bib1","volume-title":"Drug interactions","author":"Stockley","year":"1994"},{"key":"2023050812335220000_bib2","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1111\/j.1742-1241.1995.tb09915.x","article-title":"The use of long term acid suppression therapy","volume":"49","author":"Rubin","year":"1995","journal-title":"Br J Clin Pract"},{"key":"2023050812335220000_bib3","first-page":"A19","article-title":"Long term prescribing of proton pump inhibitors in general practice: clinical and cost implications (Abstract)","volume":"112","author":"Hungin","year":"1997","journal-title":"Gastroenterology"},{"key":"2023050812335220000_bib4","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1111\/j.1365-2125.1992.tb05656.x","article-title":"A study of the interaction of omeprazole and warfarin in anticoagulated patients","volume":"34","author":"Unge","year":"1992","journal-title":"Br J Clin Pharmacol"},{"key":"2023050812335220000_bib5","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1097\/00007691-198903000-00010","article-title":"Stereoselective interaction of omeprazole with warfarin in healthy men","volume":"11","author":"Sutfin","year":"1989","journal-title":"Therapeut Drug Monitor"},{"issue":"S1","key":"2023050812335220000_bib6","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1111\/j.1365-2036.1994.tb00265.x","article-title":"Safety of proton pump inhibitors - an overview","volume":"8","author":"Arnold","year":"1994","journal-title":"Aliment Pharmacol Ther"}],"container-title":["Postgraduate Medical Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/pmj\/article-pdf\/75\/890\/721\/50225480\/postgradmedj-75-721.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/pmj\/article-pdf\/75\/890\/721\/50225480\/postgradmedj-75-721.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,5,8]],"date-time":"2023-05-08T12:34:06Z","timestamp":1683549246000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/pmj\/article\/75\/890\/721\/7040225"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1999,12,1]]},"references-count":6,"journal-issue":{"issue":"890","published-online":{"date-parts":[[1999,12,1]]},"published-print":{"date-parts":[[1999,12,1]]}},"URL":"https:\/\/doi.org\/10.1136\/pgmj.75.890.721","relation":{},"ISSN":["0032-5473","1469-0756"],"issn-type":[{"value":"0032-5473","type":"print"},{"value":"1469-0756","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[1999,12]]},"published":{"date-parts":[[1999,12,1]]}}}