A 32‐year‐old woman with a history of deep vein thrombosis (DVT), steroid‐dependent ulcerative colitis, and osteoporosis was prescribed azathioprine for a steroid‐sparing effect. Stable, therapeutic ...international normalized ratios (INRs) were obtained with warfarin 35 mg/week during a 6‐week postpartum course to treat an initial DVT. Ten days after completing warfarin therapy, azathioprine was begun. A recurrent DVT occurred 9 days later, and an increase in warfarin dosage to 120 mg/week was necessary to achieve an INR of 2.0–3.0. The patient denied changes in warfarin adherence, dietary vitamin K intake, or medical conditions. The addition of azathioprine was the only change in her regimen. Review of the literature found only limited reports of an interaction between warfarin and azathioprine, with increases in warfarin requirements of 3–4 times. Careful monitoring and caution are recommended when administering these two drugs concomitantly.
A concurrent resolution recognizing the importance of raising public awareness of deep-vein thrombosis (DVT) was passed by the state legislature and signed on February 12, 2008, declaring June 4, ...2008, Oklahoma DVT Awareness Day and June 2008, Oklohoma DVTAwareness Month. As part of this effort, the Oklahoma State Medical Association is actively involved in the education of health professionals about DVT. This resolution was co-authored by State Senator Johnnie Crutchfield, and State Representatives Greg Piatt and Dr. Doug Cox.
PDF
