PROTEASE INHIBITORS AND WARFARIN AND OTHER ORAL ANTICOAGULANTS
Ritonavir has been predicted to raise warfarin levels and INRs. This was confirmed by one case report, whereas two others found entirely the opposite. A case report suggests that indinavir might cause a moderate reduction in anticoagulation. There is also a report of a marked reduction in anticoagulation in a patient taking acenocoumarol with ritonavir or nelfinavir. An isolated report describes a gradual INR rise in an elderly patient taking warfarin with saquinavir.
It would seem prudent to monitor any anticoagulant/protease inhibitor combin- ation for an alteration in anticoagulant effect, although current evidence tends to suggest that a clinically significant interaction is rare.
It would seem prudent to monitor any anticoagulant/protease inhibitor combin- ation for an alteration in anticoagulant effect, although current evidence tends to suggest that a clinically significant interaction is rare.