Hemoptysis due to aspirin treatment alternative to warfarin therapy in a patient with atrial fibrillation

Intern Med. 2015;54(20):2615-8. doi: 10.2169/internalmedicine.54.4695. Epub 2015 Oct 15.

Abstract

An 80-year-old female with a history of hypertension and atrial fibrillation had been receiving warfarin anticoagulant therapy and had stably maintained an international normalized ratio (INR) within the 2.0-3.0 range. Due to dental extractions, she was prescribed aspirin (100 mg/day) as an alternative therapy to warfarin. Three days later, the patient complained of hemoptysis without obvious inducement and the INR was 3.51. The aspirin was immediately discontinued and intravenous vitamin K was administered. Hemoptysis did not reappear and the INR returned to the normal limits. According to the Drug Interaction Probability Scale, a causal relationship between aspirin and warfarin and an increased INR value is possible.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged, 80 and over
  • Anticoagulants / adverse effects*
  • Anticoagulants / therapeutic use
  • Aspirin / adverse effects*
  • Aspirin / therapeutic use
  • Atrial Fibrillation / drug therapy*
  • Drug Interactions
  • Female
  • Hemoptysis / chemically induced*
  • Hemoptysis / drug therapy
  • Humans
  • International Normalized Ratio
  • Tooth Extraction
  • Vitamin K / therapeutic use
  • Warfarin / administration & dosage*
  • Warfarin / therapeutic use

Substances

  • Anticoagulants
  • Vitamin K
  • Warfarin
  • Aspirin