Interaction between gemcitabine and warfarin causing gastrointestinal bleeding in a patient with pancreatic cancer.

Gemcitabine (Gemzar) is the only chemotherapeutic agent approved by the U.S. Food and DrugAdministration (FDA) for the treatment of advanced pancreatic cancer. Thromboembolism requiring anticoagulation is a common paraneoplastic complication in these patients. We report a case of patient with pancre...

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Publicado en:Journal of Applied Research Vol. 5; no. 3; pp. 434 - 438
Autor principal: Saif MW
Formato: case study Journal Article
Publicado: Therapeutic Solutions LLC 2005
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Therapeutic Solutions LLC
      place: Newtown, Pennsylvania
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        atl: Interaction between gemcitabine and warfarin causing gastrointestinal bleeding in a patient with pancreatic cancer.
      aug:
        au: Saif MW
        affil: Section of Medical Oncology, Yale University School of Medicine, New Haven, CT
      sug:
        subj:
          Antineoplastic Agents Adverse Effects
          Antineoplastic Agents Therapeutic Use
          Chemotherapy, Cancer
          Drug Interactions
          Pancreatic Neoplasms Drug Therapy
          Warfarin Adverse Effects
          Warfarin Therapeutic Use
          Aged
          Atrial Fibrillation
          Endoscopy Methods
          Gastrointestinal Diseases Etiology
          Hemorrhage Etiology
          Male
          Pancreatic Neoplasms Complications
          Pancreatic Neoplasms Radiography
          Thromboembolism Etiology
          Ulcer Etiology
          Aged: 65+ years
          Male
      ab: Gemcitabine (Gemzar) is the only chemotherapeutic agent approved by the U.S. Food and DrugAdministration (FDA) for the treatment of advanced pancreatic cancer. Thromboembolism requiring anticoagulation is a common paraneoplastic complication in these patients. We report a case of patient with pancreatic cancer, complicated by gastrointestinal bleeding following therapy with concomitant gemcitabine-warfarin (Coumadin).The patient was a 65-year-old male with medical history notable for atrial fibrillation for which he was taking warfarin 57.5 mg/week (international normalized ratio [INR] 1.94). He received capecitabine-radiotherapy for locally advanced pancreatic cancer. Later, he developed multiple liver metastases. The patient was started on gemcitabine. At the end of first cycle, he experienced bright red blood per rectum. His platelet count was normal, but his INR was noted to be significantly elevated at 8.00. Esophagogastroduodenoscopy (EGD) revealed 2 antral ulcers and a duodenal ulcer. The patient was stabilized and recovered without further incident.Patients with pancreatic cancer who receive warfarin and gemcitabine should be monitored for any potential drug interactions. Weekly prothrombin time (PT)/INRs for anticoagulated patients receiving gemcitabine is suggested.
      pubtype: Academic Journal
      doctype:
        case study
        Journal Article
      ougenre: Article
    language: English
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