Rosuvastatin-acenocoumarol interaction.

BACKGROUND: Previous evidence suggests that hydroxymethylglutaryl coenzyme A-reductase inhibitors (statins) might potentiate the effect of oral anticoagulants, but a MEDLINE search (key terms: stains, rosuvastatin, anticoagulants, acenocoumarol, and interaction; years: 1980-2005) revealed no reports of an interaction between rosuvastatin and acenocoumarol. OBJECTIVE: The aim of this article was to describe a case of possible interaction between rosuvastatin and acenocoumarol. METHODS: We report the case of a 36-year-old male patient receiving long-term oral treatment with acenocoumarol, a synthetic coumarin anticoagulant, who experienced an increase in international normalized ratio (INR) and a hematoma in the left leg approximately 45 days after the initiation of treatment with rosuvastatin. RESULTS: After discontinuation of both drugs, an unexpectedly rapid decrease in INR was observed. CONCLUSIONS: Based on the results of this case, a possible pharmacologic interaction between rosuvastatin and acenocoumarol should be considered. Rosuvastatin might enhance the anticoagulant effect of acenocoumarol, and a rebound effect in cases of simultaneous discontinuation of both drugs might occur. Rosuvastatin should be administered with extreme caution in patients receiving long-term acenocoumarol therapy.