AREDS Formula, Warfarin, and Bleeding: A Case Report from the Michigan Anticoagulation Quality Improvement Initiative
Importance. The anticoagulant warfarin has been shown to interact with other medications, vitamin K containing foods, and over-the-counter products. These interactions may inhibit or potentiate the effect of warfarin, resulting in serious clotting or bleeding events. Observations. We report the cas...
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| Format: | Article |
| Language: | English |
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Wiley
2014-01-01
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| Series: | Case Reports in Medicine |
| Online Access: | http://dx.doi.org/10.1155/2014/754147 |
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| author | Eric Puroll Steven T. Heidt Brian Haymart James B. Froehlich Eva Kline-Rogers Geoffrey D. Barnes |
| author_facet | Eric Puroll Steven T. Heidt Brian Haymart James B. Froehlich Eva Kline-Rogers Geoffrey D. Barnes |
| author_sort | Eric Puroll |
| collection | DOAJ |
| description | Importance. The anticoagulant warfarin has been shown to interact with other medications, vitamin K containing foods, and over-the-counter products. These interactions may inhibit or potentiate the effect of warfarin, resulting in serious clotting or bleeding events. Observations. We report the case of an 84-year-old woman with atrial fibrillation, prescribed warfarin in May 2010 for stroke prevention. Her international normalized ratio (INR) was stable until April 2013, when she was prescribed AREDS (Age Related Eye Disease Study) formula pills, an eye vitamin compound, to slow the progression of age-related macular degeneration. This change was not reported to the Anticoagulation Service. Eighteen days later, she presented to the ED with groin and back pain and an INR of 10.4. An abdominal CT revealed a retroperitoneal hemorrhage with extension in multiple muscles. Both warfarin and AREDS were discontinued and the patient was discharged to subacute rehabilitation. This case was reviewed by the Anticoagulation Service and actions were taken to prevent similar adverse events. Conclusions. This report provides an example of the potential danger of supplement use, in this case, AREDS formula, in patients prescribed warfarin, and the importance of communicating medication changes to the providers responsible for warfarin management. |
| format | Article |
| id | doaj-art-9dc48ba5b0fc4b71a6e298e21a9ca4d4 |
| institution | OA Journals |
| issn | 1687-9627 1687-9635 |
| language | English |
| publishDate | 2014-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Medicine |
| spelling | doaj-art-9dc48ba5b0fc4b71a6e298e21a9ca4d42025-08-20T02:20:29ZengWileyCase Reports in Medicine1687-96271687-96352014-01-01201410.1155/2014/754147754147AREDS Formula, Warfarin, and Bleeding: A Case Report from the Michigan Anticoagulation Quality Improvement InitiativeEric Puroll0Steven T. Heidt1Brian Haymart2James B. Froehlich3Eva Kline-Rogers4Geoffrey D. Barnes5University of Michigan Health System, Domino’s Farms, Lobby A, MCORRP, 24 Frank Lloyd Wright Drive, Ann Arbor, MI 48106, USAUniversity of Michigan Health System, Domino’s Farms, Lobby A, MCORRP, 24 Frank Lloyd Wright Drive, Ann Arbor, MI 48106, USAUniversity of Michigan Health System, Domino’s Farms, Lobby A, MCORRP, 24 Frank Lloyd Wright Drive, Ann Arbor, MI 48106, USAUniversity of Michigan Health System, Domino’s Farms, Lobby A, MCORRP, 24 Frank Lloyd Wright Drive, Ann Arbor, MI 48106, USAUniversity of Michigan Health System, Domino’s Farms, Lobby A, MCORRP, 24 Frank Lloyd Wright Drive, Ann Arbor, MI 48106, USAUniversity of Michigan Health System, Domino’s Farms, Lobby A, MCORRP, 24 Frank Lloyd Wright Drive, Ann Arbor, MI 48106, USAImportance. The anticoagulant warfarin has been shown to interact with other medications, vitamin K containing foods, and over-the-counter products. These interactions may inhibit or potentiate the effect of warfarin, resulting in serious clotting or bleeding events. Observations. We report the case of an 84-year-old woman with atrial fibrillation, prescribed warfarin in May 2010 for stroke prevention. Her international normalized ratio (INR) was stable until April 2013, when she was prescribed AREDS (Age Related Eye Disease Study) formula pills, an eye vitamin compound, to slow the progression of age-related macular degeneration. This change was not reported to the Anticoagulation Service. Eighteen days later, she presented to the ED with groin and back pain and an INR of 10.4. An abdominal CT revealed a retroperitoneal hemorrhage with extension in multiple muscles. Both warfarin and AREDS were discontinued and the patient was discharged to subacute rehabilitation. This case was reviewed by the Anticoagulation Service and actions were taken to prevent similar adverse events. Conclusions. This report provides an example of the potential danger of supplement use, in this case, AREDS formula, in patients prescribed warfarin, and the importance of communicating medication changes to the providers responsible for warfarin management.http://dx.doi.org/10.1155/2014/754147 |
| spellingShingle | Eric Puroll Steven T. Heidt Brian Haymart James B. Froehlich Eva Kline-Rogers Geoffrey D. Barnes AREDS Formula, Warfarin, and Bleeding: A Case Report from the Michigan Anticoagulation Quality Improvement Initiative Case Reports in Medicine |
| title | AREDS Formula, Warfarin, and Bleeding: A Case Report from the Michigan Anticoagulation Quality Improvement Initiative |
| title_full | AREDS Formula, Warfarin, and Bleeding: A Case Report from the Michigan Anticoagulation Quality Improvement Initiative |
| title_fullStr | AREDS Formula, Warfarin, and Bleeding: A Case Report from the Michigan Anticoagulation Quality Improvement Initiative |
| title_full_unstemmed | AREDS Formula, Warfarin, and Bleeding: A Case Report from the Michigan Anticoagulation Quality Improvement Initiative |
| title_short | AREDS Formula, Warfarin, and Bleeding: A Case Report from the Michigan Anticoagulation Quality Improvement Initiative |
| title_sort | areds formula warfarin and bleeding a case report from the michigan anticoagulation quality improvement initiative |
| url | http://dx.doi.org/10.1155/2014/754147 |
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