Evidence map›Paper›PMID 30479741›Full record

ArticleTherapeutic advances in drug safety2018

Significant drug-drug interaction between warfarin and nafcillin.

Cynthia A King, Kathleen M Babcock, Rhianna J Godios, Benjamin S King

Open access · bronzeAbstract readCase Reports
In one paragraph

Article in Therapeutic advances in drug safety, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.2field-weighted citation impact, top 22% 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

4 citing papers in PubMed, 10 citations in OpenAlex.

  1. Article
  2. Article
  3. Drug Interactions Affecting Oral Anticoagulant Use.Circulation. Arrhythmia and electrophysiology · 2022
    Review
  4. 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

4 authors at 2 institutions in 1 country.

Cynthia A KingMetroHealth System, Clinical Pharmacy, 2500 MetroHealth Drive, Cleveland, OH 44109, USA.
Kathleen M BabcockSumma Health System, Summa Anticoagulation Management Service, Akron, Ohio, USA.
Rhianna J GodiosSumma Health System, Summa Anticoagulation Management Service, Akron, Ohio, USA.
Benjamin S KingMetroHealth System, Clinical Pharmacy, Cleveland, Ohio, USA.
MetroHealth · USSumma Health System · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Nafcillin, a beta-lactam semisynthetic penicillin, is highly resistant to penicillinase and is similar to other penicillins except that it is primarily metabolized in the liver. It is believed that nafcillin causes CYP3A4 enzyme induction which decreases warfarin's half-life. The onset of CYP3A4 induction by nafcillin occurs within the first 7 days, but maximal effects may take up to 2 weeks. Once nafcillin is discontinued, the effects persist for several weeks. A 79-year-old male with a history of atrial fibrillation and a 53-year-old male with a history of recurrent venous thromboembolism required significantly higher weekly warfarin doses during courses of nafcillin therapy. Both patients required a 2.5-3.5-fold increase from their baseline weekly warfarin dose to achieve therapeutic international normalized ratios (INRs) while on nafcillin. Traditional protocol-driven warfarin management can result in suboptimal anticoagulation in patients on warfarin and nafcillin.

Indexed as

CYP 3A4 inductiondrug interactionsnafcillinsubtherapeutic INRwarfarin

Identifiers

PMID30479741
PMCPMC6243422
OpenAlexW2889461806

What OpenQuestion holds

Textmetadata
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.