การศึกษาแบบย้อนหลังเพื่อศึกษาผลของสมุนไพรหรืออาหารเสริมต่อค่าไอเอ็นอาร์ในผู้ป่วยที่ใช้ยาวาร์ฟาริน ณ โรงพยาบาลพระมงกุฎเกล้า The Effects of Herbs or Dietary Supplements on International Normalized ratio in Warfarin Users: A Retrospective Study at Phramongk

Abstract

Objective: To evaluate the effects of herb and dietary supplement productson the INR in patients using warfarin. Methods: In this retrospectiveobservational study, data from medical records and warfarin clinic form ofthe patients visiting warfarin clinic of Phramongkutklao Hospital, Bangkok,Thailand, during Jan. 1, 2013, to Dec. 31, 2014, were abstracted. Dataregarding the product strength, dosing regimen and duration of use werecollected. Each episode of the product use was considered an individualreport. Methods: Of all 101 patients, 30 patients took the products with 35individual reports of product use. Of the 35 reports, 94.3% had INR out ofthe target goal. The most used products were rice bran oil (25.7%),followed by Curcuma longa (11.4%), pomegranate juice and Camelliasinensis (8.6% each). Products that increased INR included rice bran oil,pomegranate juice and Moringa oleifera; while those reducing INR wereCamellia sinensis and vitamin C. Conclusion: The use of herbs anddietary supplement products in patients with warfarin use could cause INRchange which could lead to abnormal bleeding or thrombosis.Keywords: warfarin, INR, herbs, dietary supplements