The influence of excessive consumption of liquorice on phenprocoumon (Marcumar®): a case report
Here, the case of a 92-year-old female patient, who was diagnosed with atrial fibrillation and treated with phenprocoumon (Marcumar®), is reported. Pre-existing comorbidities were arterial hypertension, coronary heart disease, diabetes mellitus type 2, mild senile dementia and renal insufficiency. D...
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2021
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oai:doaj.org-article:31577f76f0f24a7b98d16250f3a6d3ea2021-12-02T03:04:20ZThe influence of excessive consumption of liquorice on phenprocoumon (Marcumar®): a case report1473-230010.1177/03000605211049649https://doaj.org/article/31577f76f0f24a7b98d16250f3a6d3ea2021-11-01T00:00:00Zhttps://doi.org/10.1177/03000605211049649https://doaj.org/toc/1473-2300Here, the case of a 92-year-old female patient, who was diagnosed with atrial fibrillation and treated with phenprocoumon (Marcumar®), is reported. Pre-existing comorbidities were arterial hypertension, coronary heart disease, diabetes mellitus type 2, mild senile dementia and renal insufficiency. Despite treatment with phenprocoumon (Marcumar®), the patient experienced an ischaemic stroke. Her measured international normalized ratio (INR)-values during the months before the stroke were within the therapeutic range of 2–3, then suddenly decreased to 1.25. A retrospective inquiry failed to identify any significant changes in behaviour or therapy adherence, other than the consumption of 1.5 kg (3.3 lb) of hard-boiled candy liquorice in the days leading up to the stroke. The sudden decrease in INR-values may be explained by the influence of liquorice and its compounds on the pharmacokinetics of phenprocoumon (Marcumar®). In this context, the most important factors are the susceptibility of vitamin K antagonists to nutrition or metabolic irregularities, the influence of liquorice on the function of isoenzymes of the cytochrome P450 family that may lead to reduced bioavailability of phenprocoumon, and the influence of liquorice on peroxisome proliferator-activated receptor alpha transactivation.Hermann Casper RoemerLuisa KunzSuzan BotzenhardtSAGE PublishingarticleMedicine (General)R5-920ENJournal of International Medical Research, Vol 49 (2021) |
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DOAJ |
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Medicine (General) R5-920 |
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Medicine (General) R5-920 Hermann Casper Roemer Luisa Kunz Suzan Botzenhardt The influence of excessive consumption of liquorice on phenprocoumon (Marcumar®): a case report |
| description |
Here, the case of a 92-year-old female patient, who was diagnosed with atrial fibrillation and treated with phenprocoumon (Marcumar®), is reported. Pre-existing comorbidities were arterial hypertension, coronary heart disease, diabetes mellitus type 2, mild senile dementia and renal insufficiency. Despite treatment with phenprocoumon (Marcumar®), the patient experienced an ischaemic stroke. Her measured international normalized ratio (INR)-values during the months before the stroke were within the therapeutic range of 2–3, then suddenly decreased to 1.25. A retrospective inquiry failed to identify any significant changes in behaviour or therapy adherence, other than the consumption of 1.5 kg (3.3 lb) of hard-boiled candy liquorice in the days leading up to the stroke. The sudden decrease in INR-values may be explained by the influence of liquorice and its compounds on the pharmacokinetics of phenprocoumon (Marcumar®). In this context, the most important factors are the susceptibility of vitamin K antagonists to nutrition or metabolic irregularities, the influence of liquorice on the function of isoenzymes of the cytochrome P450 family that may lead to reduced bioavailability of phenprocoumon, and the influence of liquorice on peroxisome proliferator-activated receptor alpha transactivation. |
| format |
article |
| author |
Hermann Casper Roemer Luisa Kunz Suzan Botzenhardt |
| author_facet |
Hermann Casper Roemer Luisa Kunz Suzan Botzenhardt |
| author_sort |
Hermann Casper Roemer |
| title |
The influence of excessive consumption of liquorice on phenprocoumon (Marcumar®): a case report |
| title_short |
The influence of excessive consumption of liquorice on phenprocoumon (Marcumar®): a case report |
| title_full |
The influence of excessive consumption of liquorice on phenprocoumon (Marcumar®): a case report |
| title_fullStr |
The influence of excessive consumption of liquorice on phenprocoumon (Marcumar®): a case report |
| title_full_unstemmed |
The influence of excessive consumption of liquorice on phenprocoumon (Marcumar®): a case report |
| title_sort |
influence of excessive consumption of liquorice on phenprocoumon (marcumar®): a case report |
| publisher |
SAGE Publishing |
| publishDate |
2021 |
| url |
https://doaj.org/article/31577f76f0f24a7b98d16250f3a6d3ea |
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