Doorgeschoten INR door gelijktijdig gebruik van acenocoumarol en capecitabine

Background

A drug interaction between capecitabine and coumarin may result in an increased INR and bleeding complications.

Case description

We describe an 80-year-old woman who presented with rectal bleeding and an increased INR due to the concomitant use of acenocoumarol and capecitabine for atrial fibrillation and metastatic cecal cancer, respectively.

Conclusion

In patients with a compelling indication for treatment with capecitabine and anticoagulant therapy, conversion to low-molecular weight heparin should be considered.

Conflict of interest: none declared. Financial support: none declared