A report of a fatal interaction between Azithromycin tablets and Warfarin tablets

Introduction :Azithromycin is a type of antibiotic from the group of macrolides, which is used to treat some bacterial infections such as middle ear infection, strep throat, pneumonia, traveler's diarrhea, gastro-intestinal inflammations and sexually transmitted diseases such as chlamydia infection and gonorrhea. Cases of its use for malaria have also been observed. This medicine is taken orally or intravenously once a day. This drug stops bacterial growth by reducing protein production. The place of its metabolism is in the liver and its elimination route is biliary and renal (۴.۵%). After taking the first dose of ۵۰۰ mg, the half-life of the drug is ۱۱ to ۱۴ hours. The half-life is ۶۸ hours after taking several consecutive doses. Common side effects of Azithromycin include nausea, vomiting, diarrhea, and stomach upset. In addition, an allergic reaction such as anaphylaxis, Cutie's syndrome or a diarrhea caused by pseudomembranous enterocolitis can also be among the effects of taking this drug. Azithromycin may interact with some medications, especially Carbamazepine, Terfenadine, Cyclosporine, anticoagulants (blood thinners such as Warfarin), Theophylline, and Aluminum/Magnesium-containing antacids.Warfarin or Coumadin is a blood anticoagulant pill that inhibits the coagulation factors that need vitamin K for their activity by inhibiting the activity of vitamin K and leads to a decrease in the possibility of clot formation. Warfarin does not thin the blood, nor does it dissolve clots that have already formed. Rather, it slows down the blood clotting process. This medicine is used in cases where the probability of thrombosis or vascular embolism is high, such as after open heart surgery, stroke, etc. People who are being treated with Warfarin should consult their doctor when consuming ginger, garlic, green tea, parsley, nettle, grapefruit, soy, mango, turmeric, onion, liver, oil and alcohol, because these substances have serious interactions with They are taking warfarin. The most common side effect of Warfarin is bleeding from different parts of the body. Even when the patient's INR is within the target range, some bleeding may occur.Purpose:The aim of this study was to report a case of fatal interaction between Azithromycin tablets and Warfarin tablets.Patient introduction:a ۲۷-year-old newlywed who suffered deep vein thrombosis (DVT) due to an injury to his right leg and was treated with Warfarin tablets. To treat a cold, he took ۱ gram of Azithromycin daily and after ۳ days He suffered from disseminated intravascular coagulation (DIC) and died. Discussion and conclusion:This is a serious warning to never choose Azithromycin as an antibiotic treatment in patients with a history of Warfarin use, because Azithromycin leads to several complications of Warfarin, i.e. extensive bleeding from the stomach, intestine, bladder and all organs of the body.

کلیدواژه ها:

Interaction ، Azithromycin tablets ، Warfarin tablets