Evaluation of the anticoagulant effect and timing of the concomitant use of S-1 and warfarin

J Int Med Res. 2016 Oct;44(5):1123-1130. doi: 10.1177/0300060516658162. Epub 2016 Sep 27.

Abstract

Objectives To evaluate the effects of the timing of warfarin (WF) administration in patients with gastric cancer who received S-1 oral chemotherapy. Methods This retrospective chart review collected patient data including the prothrombin time international normalized ratio (PT-INR). Patients were categorized into three groups based on the timing of WF administration in relation to S-1 oral chemotherapy: group A patients received WF before S-1 chemotherapy; group B patients started WF during S-1 chemotherapy; and group C patients started WF after completing S-1 chemotherapy. Results A total of 21 patients with gastric cancer were included in the study; group A ( n = 8), group B ( n = 10) and group C ( n = 3). Seven patients (88%) in group A, seven (70%) in group B and all of the patients (100%) in group C had >2.5 PT-INR. There was no significant difference in the time-to-exceed 2.5 PT-INR between groups A and B. Conclusions These findings suggest that the timing of WF use in relation to S-1 chemotherapy might not be an important factor for PT-INR, although the low patient numbers included in the study should be taken into consideration.

Keywords: S-1; drug interaction; prothrombin time international normalized ratio (PT-INR); warfarin.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anticoagulants / administration & dosage
  • Anticoagulants / therapeutic use*
  • Antimetabolites, Antineoplastic / administration & dosage
  • Antimetabolites, Antineoplastic / therapeutic use*
  • Drug Combinations
  • Drug Interactions
  • Female
  • Humans
  • International Normalized Ratio
  • Male
  • Middle Aged
  • Oxonic Acid / administration & dosage*
  • Oxonic Acid / therapeutic use*
  • Prothrombin Time
  • Retrospective Studies
  • Stomach Neoplasms / drug therapy*
  • Tegafur / administration & dosage*
  • Tegafur / therapeutic use*
  • Warfarin / administration & dosage*
  • Warfarin / therapeutic use*

Substances

  • Anticoagulants
  • Antimetabolites, Antineoplastic
  • Drug Combinations
  • S 1 (combination)
  • Tegafur
  • Warfarin
  • Oxonic Acid