• Ugeskrift for laeger · Jun 2015

    Case Reports

    [Fatal intracerebral haemorrhage possibly caused by interaction between paracetamol and warfarin].

    • Signe Vinsand Naver, Maria Papina, Espen Jimenez Solem, and Kim Peder Dalhoff.
    • Klinisk Farmakologisk Afdeling, Bispebjerg Hospital, Bispebjerg Bakke 23, 2400 København NV. signe.vinsand.naver@regionh.dk.
    • Ugeskr. Laeg. 2015 Jun 1; 177 (23): V12140685.

    AbstractThis is a case report of an 83-year-old man in warfarin treatment with stable international normalised ratio (INR) after aortic valve replacement and atrial fibrillation. Due to back pain he took paracetamol (acetaminophen) 4 g/day, morphine 30 mg/day and diclofenac as rescue medication for two weeks. After 14 days of treatment he was admitted to a hospital with acute neurological deficits, and a blood sample showed INR levels above 10. A CT-scan of the brain showed an intracerebral haemorrhage. The patient died eight days after admission. Mechanisms of the possible interaction between paracetamol and warfarin are discussed.

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