Subcutaneous hemorrhage induced by the combined use of warfarin and traditional Chinese medicine
ZHAI Hui-yuan
WU Ding-kun
SU Xiao-ye
Abstract：A 77-year-old female patient with atrial fibrillation took warfarin regularly (2.5 mg once daily for 17 months). During the medication, the results of INR reached the standard and were steady. A week ago, the patient felt pain in lower limbs, and was diagnosed with vasculitis by traditional Chinese medicine department and took decoction of traditional Chinese medicine. On the sixth day, the patient found multiple ecchymosis on her arms, waist and legs. On the seventh day, the patient was admitted to hospital because of the worsening of the ecchymosis. The INR increased to 7.35. Warfarin and the traditional Chinese medicine were withdrawn immediately, meanwhile, the vitamin K1was injected for reversing the anticoagulant effect of warfarin. Three days later, the INR decreased to 1.58, and warfarin (2.5 mg daily) was taken. Twelve days later, the area of ecchymosis reduced by half, and the INR was 2.25. The results of the follow-up visit by clinical pharmacists showed that the ecchymosis disappeared completely and the INRs were 2.45 and 2.21 in one week and two weeks after discharge, respectively.
Keywords：WarfarinHemorrhageTraditional Chinese medicineDrug interactionAdverse drug reaction
Publication Date：2018-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：3( 62-64 )