Warfarin Institute of America
DEDICATED TO YOUR HEALTH SINCE 2000
AN IMPORTANT NOTICE FOR PEOPLE WHO ARE ON BOTH WARFARIN (Coumadin, Jantoven) and DAPTOMYCIN (Cubicin) AND GET TESTED WITH CERTAIN LAB TESTS.
THIS IS A VERY SMALL GROUP OF PEOPLE WHO TAKE BOTH WARFARIN AND DAPTOMYCIN (CUBICIN) AN INTRVENOUS ANTIBIOTIC AND ARE TESTED ONLY WITH THESE TWO REAGENTS BY INTRAVENOUS BLOOD DRAW IN A COMMERCIAL LAB
In a letter dated April 12, 2006, Cubist Pharmaceuticals warned of an interference between their antibiotic daptomycin (Cubicin) and some of the reagents used to test PT/INRs in hospital labs. The reagents involved are HemosIL RecombiPlasTin and Hemoliance RecombiPlasTin. There is nothing wrong with these reagents. It appears that when people are taking daptomycin and warfarin and they have their INR tested with one of these kits, the INR number can be falsely high. If this happens, the erroneous lab results could cause an unnecessary delay in getting surgery done, incorrectly changing the warfarin dose, or giving medications to counteract the warfarin.
The falsely elevated numbers were high enough to cause panic if they were correct.
If this happens, the physician should order a PT/INR to be done by a finger-stick test. These were not implicated in the incidents of interference. This would be quicker than using the method recommended by the company. Cubist Pharmaceuticals recommends that if these brands of reagents are being used, then another PT/INR be done just prior to the next daptomycin dose.
It is important to keep in mind that there could also be a truly elevated PT/INR even with this combination. In this case the patient needs to be evaluated for why this occurred and appropriate action taken.
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Last updated May 12, 2006
