Letters

Monitoring may need to be prolonged in patients given warfarin and amiodarone

BMJ 1996; 313 doi: https://doi.org/10.1136/bmj.313.7052.301b (Published 03 August 1996) Cite this as: BMJ 1996;313:301
  1. Brian Tomlinson,
  2. Robert P Young,
  3. Thomas Y K Chan,
  4. Julian A J H Critchley,
  5. Juliana C N Chan
  1. Professor Assistant professor Associate professor Professor Associate professor Department of Clinical Pharmacology, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong

    EDITOR,—B Cheung and colleagues report a case from Hong Kong illustrating a potential latent interaction between warfarin and amiodarone.1 They detail the pharmacokinetics of amiodarone and how these may have contributed to the problem but do not discuss the pharmacodynamics of warfarin, which may also be relevant.

    Warfarin has a relatively long elimination half life (average about 35 hours for the racemate) and takes at least a week to reach steady state plasma concentrations.2 The half life for the biological effect varies for the different vitamin K dependent coagulation factors, and changes …

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