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KMID : 0882420110800060729
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Korean Journal of Medicine
2011 Volume.80 No. 6 p.729 ~ p.733
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A Case of Elevated Prothrombin Time-International Normalized Ratio (PT-INR) Associated with Concurrent Use of Erlotinib and Warfarin
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Kim Seung-Kyoung
Park Kyung-Seon
Choi Seung-Hwa
Byeon Jae-Ho
Woo In-Sook
Han Chi-Hwa
Kim Hyo-Lim
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Abstract
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Erlotinib, an orally active epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI), is indicated for EGFR mutation-positive patients with poor performance status. Erlotinib is also used as a second-line agent in patients who show disease progression after failure of first-line therapy. Warfarin is administered in patients with advanced cancer for the prevention or treatment of venous thromboembolism. Both erlotinib and warfarin are metabolized in the human liver primarily by the CYP3A4 enzyme system. Thus, erlotinib may inhibit the metabolism of warfarin and clinicians should pay attention to the possible interaction between the two drugs when they are administered concurrently. We report the case of a 50-year-old man who showed changes in the prothrombin time-international normalized ratio (PT-INR) after coadministration of erlotinib and warfarin.
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KEYWORD
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Erlotinib, Warfarin, Prothrombin time, Carcinoma, Non-small cell lung
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