Warfarin and celecoxib interaction in the setting of cytochrome P450 (CYP2C9) polymorphism with bleeding complication

H. Malhi, B. Atac, A. K. Daly, S. Gupta

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Drug metabolism may be perturbed by genetically determined differences in the metabolic activity of cytochrome P450 enzymes. The authors encountered extensive bleeding in a patient receiving warfarin for anticoagulation after the introduction of celecoxib, an anti-inflammatory drug. As the CYP2C9 enzyme metabolises these drugs, it was determined whether variant alleles were responsible for altering warfarin handling. Genetic analysis established that the patient was a compound heterozygote with CYP2C9*2 and *3 variant alleles, which exhibit lower drug metabolising capacity and enhance susceptibility to drug toxicity.

Original languageEnglish (US)
Pages (from-to)107-109
Number of pages3
JournalPostgraduate Medical Journal
Issue number940
Publication statusPublished - Feb 1 2004


ASJC Scopus subject areas

  • Medicine(all)

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