TY - JOUR
T1 - Study of co-prescription of drugs potentially interacting with warfarin in indonesian ambulatory patients
AU - Nilamsari, Wenny Putri
AU - Yusuf, Mochammad
AU - Suharjono,
AU - Pertiwi, Dita Aryanti
AU - Dery, Arina
AU - Suprapti, Budi
AU - Zulkarnaen, Bambang
N1 - Publisher Copyright:
© RJPT All right reserved.
PY - 2020/10
Y1 - 2020/10
N2 - Background: Despite the growing use of Direct Oral Anticoagulant (DOAC), the most prescribed oral anticoagulant currently in Indonesia is warfarin. Efficacy and safety of warfarin are influenced by various factors including drug-drug interactions. Patients in ambulatory care often receive more than one prescription leading to potential drug-drug interactions. However, there is no data from Indonesia has been published. This study aimed to assess the prevalence of other drugs potentially interacting with warfarin and their interaction risk. Method: It was a descriptive cross-sectional study. We identified warfarin prescriptions issued between January 2015 and December 2019 using electronic prescription and electronic medical records. Analysis of interaction risk was performed using Medscape. Result: During 4 years, there were 50 patients fulfilling inclusion criteria with 715 prescriptions issued. From 50 patients, 94 % at least received 1 concomitant drug. The four most commonly interacting drugs prescribed during warfarin therapy were spironolactone (58%), simvastatin (54%), allopurinol (32%) and low dose acetylsalicylic acid (20%). Furthermore, there were 38% of patients received concomitant drugs classified as serious interaction as follows allopurinol, amiodarone, and fenofibrate. As much as 16% of patients had adverse outcomes and some of this may be associated with warfarin-drug interaction. Conclusion: This study indicates that the prevalence of co-prescription with potentially interacting drugs during warfarin therapy in ambulatory patients is high. Strategy to identify and manage warfarin-drugs interaction is warranted to avoid potential adverse events.
AB - Background: Despite the growing use of Direct Oral Anticoagulant (DOAC), the most prescribed oral anticoagulant currently in Indonesia is warfarin. Efficacy and safety of warfarin are influenced by various factors including drug-drug interactions. Patients in ambulatory care often receive more than one prescription leading to potential drug-drug interactions. However, there is no data from Indonesia has been published. This study aimed to assess the prevalence of other drugs potentially interacting with warfarin and their interaction risk. Method: It was a descriptive cross-sectional study. We identified warfarin prescriptions issued between January 2015 and December 2019 using electronic prescription and electronic medical records. Analysis of interaction risk was performed using Medscape. Result: During 4 years, there were 50 patients fulfilling inclusion criteria with 715 prescriptions issued. From 50 patients, 94 % at least received 1 concomitant drug. The four most commonly interacting drugs prescribed during warfarin therapy were spironolactone (58%), simvastatin (54%), allopurinol (32%) and low dose acetylsalicylic acid (20%). Furthermore, there were 38% of patients received concomitant drugs classified as serious interaction as follows allopurinol, amiodarone, and fenofibrate. As much as 16% of patients had adverse outcomes and some of this may be associated with warfarin-drug interaction. Conclusion: This study indicates that the prevalence of co-prescription with potentially interacting drugs during warfarin therapy in ambulatory patients is high. Strategy to identify and manage warfarin-drugs interaction is warranted to avoid potential adverse events.
KW - Ambulatory Patients
KW - Co-Prescription
KW - Drug-drug interaction
KW - Indonesian
KW - Warfarin
UR - http://www.scopus.com/inward/record.url?scp=85097665117&partnerID=8YFLogxK
U2 - 10.5958/0974-360X.2020.00678.2
DO - 10.5958/0974-360X.2020.00678.2
M3 - Article
AN - SCOPUS:85097665117
SN - 0974-3618
VL - 13
SP - 3833
EP - 3836
JO - Research Journal of Pharmacy and Technology
JF - Research Journal of Pharmacy and Technology
IS - 8
ER -