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Fırat Üniversitesi Sağlık Bilimleri Tıp Dergisi
2017, Cilt 31, Sayı 2, Sayfa(lar) 097-098
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Interaction of Phenyramidol Hydrochloride and Warfarin
Samet Sancar KAYA1, Gökhan YARDIMCI2, Barış NACIR3, Hakan GENÇ3, Aynur KARAGÖZ3
1Patnos Devlet Hastanesi, Fiziksel Tıp ve Rehabilitasyon Kliniği, Ağrı, TÜRKİYE
2Kastamonu Fizik Tedavi ve Rehabilitasyon Hastanesi, Fiziksel Tıp ve Rehabilitasyon Kliniği, Kastamonu, TÜRKİYE
3Ankara Eğitim ve Araştırma Hastanesi, Fiziksel Tıp ve Rehabilitasyon Kliniği, Ankara, TÜRKİYE
Keywords: Pheniramidol hydrochloride, warfarin, drug interaction

Phenyramidol HCl is a combined analgesic and muscle relaxant drug commonly used in patients with musculoskeletal complaints. Warfarin is an oral anticoagulant that is metabolized by cytochrome p450 enzymes. Drugs which inhibit cytochrome P450 enzymes may increase the effect of warfarin.

A 53-year-old male patient presented with low back pain. The patient was using warfarin 1x5 mg / day due to heart valve replacement. On physical examination, the lumbar flexion, rotation and lateral flexion of the patient were limited and painful. In laboratory tests, INR was found 15.7 (0.8-1.2). His medical history, revealed that the patient used 400 mg of feniramidol 3 times a day for the last 10 days due to low back pain. The patient did not have active bleeding, feniramidol use was stopped and warfarin therapy was temporarily suspended. After returning to the INR in therapeutic range, warfarin therapy of 1x5 mg started again. In controls, INR remained in the therapeutic range.

The use of warfarin can sometimes lead to mortal bleeding. Therefore, in patients who use warfarin, drugs that will not interfere with warfarin should be preferred and these patients should be closely monitored.


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