{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T04:22:14Z","timestamp":1791174134216,"version":"4.1.0"},"reference-count":11,"publisher":"SAGE Publications","issue":"12","license":[{"start":{"date-parts":[[2006,12,1]],"date-time":"2006-12-01T00:00:00Z","timestamp":1164931200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Ann Pharmacother"],"published-print":{"date-parts":[[2006,12]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>A potential drug interaction exists between oral corticosteroids and warfarin, but there is limited documentation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To evaluate the potential drug interaction between oral corticosteroids and long-term warfarin therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A retrospective review was conducted of 387 medical records for active patients within an anticoagulation clinic. Inclusion criteria were stable anticoagulation therapy, short-term oral corticosteroid therapy, international normalized ratio (INR) recorded within 30 days prior to corticosteroid initiation (pre-INR), and INR recorded during corticosteroid therapy or within 14 days of discontinuation (post-INR). Patients were excluded if they had been started on any antibiotic or other drug with a probable interaction with warfarin at the same time as corticosteroid initiation. Thirty-two patient encounters met the predetermined inclusion and exclusion criteria. The primary outcome assessed was the difference between pre- and post-INR values. Secondary endpoints included bleeding events, emergency department (ED) visits, hospitalizations, and warfarin dose modifications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The mean difference between pre- and post-INR values was 1.24 (95% CI 0.86 to 1.62). Ninety-seven percent of the 32 patient encounters resulted in a change in their post-INR value, and 62.5% of patients had supratherapeutic INR values at the post-corticosteroid assessment. The majority of patients assessed had an elevation of their INR following concomitant use of warfarin and corticosteroids. The INR change was observed at a mean \u00b1 SD of 6.7 \u00b1 3.3 days following the first dose of corticosteroid. Overall, 16 patients (50%) required a modification of their anticoagulation therapy during or following corticosteroid therapy. Only one adverse event of minor epistaxis was reported, and no ED visits or hospitalizations occurred as a consequence of the drug combination.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Use of oral corticosteroids in patients on long-term warfarin therapy may result in a clinically significant interaction, which requires close INR monitoring and possible warfarin dose reduction.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1345\/aph.1h418","type":"journal-article","created":{"date-parts":[[2006,11,21]],"date-time":"2006-11-21T22:41:09Z","timestamp":1164148869000},"page":"2101-2106","source":"Crossref","is-referenced-by-count":44,"title":["Effect of Oral Corticosteroids on Chronic Warfarin Therapy"],"prefix":"10.1177","volume":"40","author":[{"given":"Kathleen A","family":"Hazlewood","sequence":"first","affiliation":[{"name":"College of Pharmacy, The University of Oklahoma Health Sciences Center, Oklahoma City, OK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan E","family":"Fugate","sequence":"additional","affiliation":[{"name":"Department of Pharmacy: Clinical and Administrative Sciences, College of Pharmacy, The University of Oklahoma Health Sciences Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donald L","family":"Harrison","sequence":"additional","affiliation":[{"name":"Department of Pharmacy: Clinical and Administrative Sciences, College of Pharmacy, The University of Oklahoma Health Sciences Center"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2006,12,1]]},"reference":[{"key":"bibr1-aph.1H418","unstructured":"The top 300 prescriptions for 2005 by number of US prescriptions dispensed. Rxlist: The Internet Drug Index. www.rxlist.com (accessed 2006 Jun 30)."},{"key":"bibr2-aph.1H418","doi-asserted-by":"publisher","DOI":"10.1378\/chest.126.3_suppl.204S"},{"key":"bibr3-aph.1H418","unstructured":"Package insert. Coumadin (warfarin sodium). Princeton, NJ: Bristol-Myers Squibb, April 2005."},{"key":"bibr4-aph.1H418","first-page":"790","volume":"4891","author":"Chatterjea JB","year":"1954","journal-title":"and cortisone on the anticoagulant activity of ethyl biscoumacetate. Br Med J"},{"key":"bibr5-aph.1H418","first-page":"530","volume":"51","author":"Menczel J","year":"1957","journal-title":"J Lab Clin Med"},{"key":"bibr6-aph.1H418","doi-asserted-by":"publisher","DOI":"10.1177\/135245859700300406"},{"key":"bibr7-aph.1H418","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-132-8-200004180-00005"},{"key":"bibr8-aph.1H418","unstructured":"Micromedex healthcare series. Drugdex System. KlascoRK, ed. Greenwood Village, CO: Thomson Micromedex, 2006."},{"key":"bibr9-aph.1H418","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199507063330103"},{"key":"bibr10-aph.1H418","first-page":"168","volume":"27","author":"Ker\u00e9veur A","year":"1997","journal-title":"Haemostasis"},{"key":"bibr11-aph.1H418","doi-asserted-by":"publisher","DOI":"10.1002\/j.1875-9114.1998.tb03830.x"}],"container-title":["Annals of Pharmacotherapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1345\/aph.1H418","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1345\/aph.1H418","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T11:11:51Z","timestamp":1777374711000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1345\/aph.1H418"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2006,12]]},"references-count":11,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2006,12]]}},"alternative-id":["10.1345\/aph.1H418"],"URL":"https:\/\/doi.org\/10.1345\/aph.1h418","relation":{},"ISSN":["1060-0280","1542-6270"],"issn-type":[{"value":"1060-0280","type":"print"},{"value":"1542-6270","type":"electronic"}],"subject":[],"published":{"date-parts":[[2006,12]]}}}