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Warfarin resistance and enteral feedings: 2 Case reports and a supporting in vitro study

  • Louis E. Penrod
    Affiliations
    Department of Physical Medicine and Rehabilitation, University of Pittsburgh School of Medicine (Penrod, Cabacungan); and private practice (Allen), Pittsburgh, PA. This work was initiated while Penrod and Allen were affiliated with the Department of Rehabilitation Medicine, University of Alabama at Birmingham
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  • Joanne B. Allen
    Affiliations
    Department of Physical Medicine and Rehabilitation, University of Pittsburgh School of Medicine (Penrod, Cabacungan); and private practice (Allen), Pittsburgh, PA. This work was initiated while Penrod and Allen were affiliated with the Department of Rehabilitation Medicine, University of Alabama at Birmingham
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  • Leonard R. Cabacungan
    Affiliations
    Department of Physical Medicine and Rehabilitation, University of Pittsburgh School of Medicine (Penrod, Cabacungan); and private practice (Allen), Pittsburgh, PA. This work was initiated while Penrod and Allen were affiliated with the Department of Rehabilitation Medicine, University of Alabama at Birmingham
    Search for articles by this author

      Abstract

      Penrod LE, Allen JB, Cabacungan LR. Warfarin resistance and enteral feedings: 2 case reports and a supporting in vitro study. Arch Phys Med Rehabil 2001;82:1270-3. This study investigated whether an interaction between common enteral feeding products and warfarin exists. Two clinical cases of apparent interaction spurred a supporting in vitro study. Both the clinical cases and the in vitro study showed that several enteral feeding products bind warfarin, reducing the bioavailability of the drug. The binding appears to occur between warfarin and the protein component of the feeding product. This clinically important interaction is likely when warfarin and enteral feeding products are used concurrently. Clinicians should be aware of this potential interaction and monitor the therapy closely, particularly when enteral feeding is discontinued. © 2001 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation

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