Erlotinib과 Warfarin의 동시 투여로 PT-INR이 연장된 1예
A Case of Elevated Prothrombin Time-International Normalized Ratio (PT-INR) Associated with Concurrent Use of Erlotinib and Warfarin
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초록
향후 활동성이 저하된 진행성 비소세포폐암 환자에서 EGFR TKI 표적치료제와 와파린을 병용하는 사례가 더욱 증가할 것으로 예상되므로 이들 약제의 잠재적인 상호작용을 고려하여 INR의 변화를 주의 깊게 관찰해야 하며 필요한 경우에는 와파린의 용량을 조절해야 한다.
Abstract
Erlotinib, an orally active epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI), is indicated for EGFR mutation-positive patients with poor performance status. Erlotinib is also used as a second-line agent in patients who show disease progression after failure of first-line therapy. Warfarin is administered in patients with advanced cancer for the prevention or treatment of venous thromboembolism. Both erlotinib and warfarin are metabolized in the human liver primarily by the CYP3A4 enzyme system. Thus, erlotinib may inhibit the metabolism of warfarin and clinicians should pay attention to the possible interaction between the two drugs when they are administered concurrently. We report the case of a 50-year-old man who showed changes in the prothrombin time-international normalized ratio (PT-INR) after coadministration of erlotinib and warfarin. (Korean J Med 2011;80:729-733)
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