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Pharmacoepidemiological assessment of drug interactions with vitamin K antagonists

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Authors:
  • PottegĂ„rd, Anton ;
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    Clinical Pharmacology and Pharmacy, Department of Public Health, Faculty of Health Sciences, SDU
  • Christensen, R. D. ;
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    Research Unit of General Practice, Department of Public Health, Faculty of Health Sciences, SDU
  • Wang, S. V. ;
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    unknown
  • Gagne, J. J. ;
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    unknown
  • Larsen, T. B. ;
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    unknown
  • Hallas, J.
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    Clinical Pharmacology and Pharmacy, Department of Public Health, Faculty of Health Sciences, SDU
DOI:
10.1002/pds.3714
Abstract:
PurposeWe present a database of prescription drugs and international normalized ratio (INR) data and the applied methodology for its use to assess drug-drug interactions with vitamin K antagonists (VKAs). We use the putative interaction between VKAs and tramadol as a case study. MethodsWe used a self-controlled case series to estimate the incidence rate ratio (IRR) comparing the rate of INR measurements of 4.0 in concomitant tramadol and VKA-exposed periods to VKA-only-exposed periods. Secondary analyses considered specific subgroups, alternative exposure criteria, alternative outcome definitions, and other drugs. ResultsWe identified 513 VKA users with at least 1 INR measurement 4.0 and concomitant tramadol and VKA exposure during the observation period. The overall IRR was 1.80 (95% confidence interval [CI], 1.53-2.10), with a stronger association among users of phenprocoumon compared to warfarin (IRR, 3.37; 95%CI, 2.50-4.53 and IRR, 1.46; 95%CI, 1.20-1.76, respectively). We observed larger IRRs with stricter outcome definitions. Concomitant tramadol and VKA exposure was also associated with an increased rate of low INR measurements (i.e.,
Type:
Journal article
Language:
English
Published in:
Pharmacoepidemiology and Drug Safety, 2014, Vol 23, Issue 11, p. 1160-1167
Main Research Area:
Medical science
Publication Status:
Published
Review type:
Peer Review
Submission year:
2014
Scientific Level:
Scientific
ID:
272591301

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