Evidence map›Paper›PMID 30285858›Full record

ReviewBMC pharmacology & toxicology2018

The critical interaction between valproate sodium and warfarin: case report and review.

Chenguang Zhou, Yi Sui, Weijin Zhao, Chunyao Dong, Li Ren, Pingmei Song, Bing Xu, Xiaohong Sun

Open access · goldAbstract readCase ReportsReview
In one paragraph

Review in BMC pharmacology & toxicology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
1.8field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 8 citations in OpenAlex.

  1. Valproate intoxication in a patient with bipolar I disorder due to SGLT2 inhibitor-induced weight reduction.Daru : journal of Faculty of Pharmacy, Tehran University of Medical Sciences · 2020
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 1 country.

Chenguang ZhouDepartment of Neurology, The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Yi SuiDepartment of Neurology, Shenyang First People's Hospital, Shenyang Brain Institute, Shenyang Medical College Affiliated Shenyang Brain Hospital, Shenyang, China. jakeyisui@icloud.com.ORCID 0000-0002-2898-7877
Weijin ZhaoDepartment of Neurology, Shenyang First People's Hospital, Shenyang Brain Institute, Shenyang Medical College Affiliated Shenyang Brain Hospital, Shenyang, China.
Chunyao DongDepartment of Neurology, Shenyang First People's Hospital, Shenyang Brain Institute, Shenyang Medical College Affiliated Shenyang Brain Hospital, Shenyang, China.
Li RenDepartment of Neurology, Shenyang First People's Hospital, Shenyang Brain Institute, Shenyang Medical College Affiliated Shenyang Brain Hospital, Shenyang, China.
Pingmei SongDepartment of Diagnostic Sonography, Shenyang First People's Hospital, Shenyang Brain Institute, Shenyang Medical College Affiliated Shenyang Brain Hospital, Shenyang, China.
Bing XuDepartment of Neurology, Shenyang First People's Hospital, Shenyang Brain Institute, Shenyang Medical College Affiliated Shenyang Brain Hospital, Shenyang, China.
Xiaohong SunDepartment of Neurology, the Fourth Affiliated Hospital, China Medical University, Shenyang, China.
Shenyang Medical College · CNFifth Affiliated Hospital of Zhengzhou University · CNFourth Affiliated Hospital of China Medical University · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundValproic acid (VPA) and warfarin are commonly prescribed for patients with epilepsy and concomitant atrial fibrillation (AF). When VPA and warfarin are prescribed together, clinically important interactions may occur. VPA may replace warfarin from the protein binding sites and result in an abnormally increased anticoagulation effect. This is commonly underrecognized. CASE PRESENTATION: In our case, we report a 78-year-old woman with a glioma who presented with status epilepticus. The patient was on warfarin to prevent cardiogenic embolism secondary to AF. Intravenous loading dose of VPA was administered, but international normalized ratio (INR) increased significantly to 8.26. Intravenous vitamin K1 was then given and the patient developed no overt bleeding during the hospitalization.

conclusionBy reviewing the literature and discussing the critical interaction between valproate sodium and warfarin, we conclude that intravenous VPA and the co-administrated warfarin may develop critical but underrecognized complications due to effects on the function of hepatic enzymes and displacement of protein binding sites.

Indexed as

AgedAnticoagulantsAnticonvulsantsAtrial FibrillationDrug InteractionsFemaleHumansInternational Normalized RatioProtein BindingStatus EpilepticusValproic AcidWarfarinAnticoagulantsAnticonvulsantsValproic AcidWarfarinEpilepsyInteractionInternational normalized ratioValproic acidWarfarin

Identifiers

PMID30285858
PMCPMC6167846
OpenAlexW2894524350

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.