Griseofulvin-warfarin antagonism

Abstract

THE DEMONSTRATION that the metabolism of one drug can alter the metabolism of another has occasioned considerable interest.¹Recent experimental work has shown that an increase within cells of the liver of smooth-surfaced endoplasmic reticulum parallels an increase of this altered metabolism.²Of further interest is the fact that the same or similar loci seem to be implicated in cholesterol synthesis.³Because it has been reported that the metabolism of both griseofulvin and coumarin congeners are increased by treatment with phenobarbital, presumably via enzyme induction,^4,5it seemed within reason that one of these might act as an inducer to accelerate metabolism of the other. It should be noted, however, that the fact that a drug either acts as an inducer or is subject to altered metabolism via enzyme induction does not necessarily indicate that it will function in both capacities. Report of Cases Case 1.— A