Pulmonary arterial hypertension is an infrequent but nevertheless serious life-threatening severe complication of HIV infection. It can be treated with bosentan and oral anticoagulants. Bosentan could induce the acenocoumarol metabolism and it increases the INR values. Until now, no study of interaction between bosentan and oral anticoagulants in HIV patients has reported. So we present a case of this interaction between these drugs and we reviewed MEDLINE to identify all the papers published so far. In our case, several weeks after increasing dose of bosentan acenocoumarol dose had to be progressively increased to 70 mg/week (+33%) without obtaining an adequate INR level (2.0-3.0). Forty-nine days later, we achieved a therapeutic INR with 90 mg/week of warfarin. The use of bosentan and oral anticoagulants together in these patients require a closer monitoring during first weeks of treatment, after increasing the bosentan dose and even during longer periods of time.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3238480PMC
http://dx.doi.org/10.4081/hr.2011.e16DOI Listing

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School of Pharmacy, Henan University of Chinese Medicine Zhengzhou 450046, China Engineering and Technology Center for Chinese Medicine Development of Henan Province Zhengzhou 450046, China Co-construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases by Henan & Education Ministry of P.R.China, Henan University of Chinese Medicine Zhengzhou 450046, China.

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