Elevated INR in a COVID-19 patient after concomitant administration of azvudine and anticoagulants

Frontiers in Pharmacology

Pharmacology

Xi Zhang¹  Ying Zhang¹  Yuqing Pei¹  Xiaojia Yu¹  Guangrun Li¹  Zihui Wang²  Fengwei Jiao³  Pengfei Li⁴ 

[1] Department of Pharmacy, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China;Department of Pharmacy, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China;Department of Chinese Communist Youth League Committee, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China;Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China;Research Ward/Phase I Clinical Trial Unit, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China;

关键词: azvudine;    warfarin;    rivaroxaban;    DDI;    international normalized ratio (INR);   

DOI  :  10.3389/fphar.2023.1191608

 received in 2023-03-22, accepted in 2023-05-02,  发布年份 2023

来源: Frontiers

【 摘 要 】

Background: Azvudine (FNC) is a promising treatment candidate for managing coronavirus disease 2019 (COVID-19). However, drug interactions with azvudine have been poorly studied, especially with no reported cases of azvudine with anticoagulants such as warfarin and rivaroxaban.Case summary: The patient was diagnosed with lower limb venous thrombosis and took warfarin regularly. The international normalized ratio (INR) was stable (2.0–3.0). However, the INR increased to 7.52 after administering azvudine. The patient had no other factors justifying this change. This increase in INR occurred again with the administration of azvudine in combination with rivaroxaban, and the INR increased to 18.91. After azvudine administration was stopped, the INR did not increase when rivaroxaban was used alone.Conclusion: Azvudine, warfarin, and rivaroxaban might have previously unidentified drug interactions that increased the INR. Therefore, the INR must be closely monitored when they are concomitantly administered in COVID-19 patients.

【 授权许可】

Unknown   
Copyright © 2023 Zhang, Jiao, Li, Yu, Pei, Zhang, Wang and Li.