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Article
February 20, 1967

Griseofulvin-Warfarin Antagonism

Author Affiliations

From the Department of Dermatology, University of Miami (Fla) School of Medicine.

JAMA. 1967;199(8):582-583. doi:10.1001/jama.1967.03120080116027
Abstract

THE DEMONSTRATION that the metabolism of one drug can alter the metabolism of another has occasioned considerable interest.1 Recent experimental work has shown that an increase within cells of the liver of smooth-surfaced endoplasmic reticulum parallels an increase of this altered metabolism.2 Of further interest is the fact that the same or similar loci seem to be implicated in cholesterol synthesis.3 Because it has been reported that the metabolism of both griseofulvin and coumarin congeners are increased by treatment with phenobarbital, presumably via enzyme induction,4,5 it 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

References
1.
Burns, J.J.:  Implications of Enzyme Induction for Drug Therapy ,  Amer J Med 37:327-331 ( (Sept) ) 1964.Crossref
2.
Orrenius, S.; Ericsson, J.L.E.; and Ernester, L.:  Phenobarbital-Induced Synthesis of the Microsomal Drug-Metabolizing Enzyme System and Its Relationship to the Proliferation of Endoplasmic Membranes ,  J Cell Biol 25:627-639 ( (June) ) 1965.Crossref
3.
Jones, A.L.. and Armstrong, D.T.:  Increased Cholesterol Biosynthesis Following Phenobarbital-Induced Hypertrophy of Agranular Endoplasmic Reticulum in Liver .  Proc Soc Exp Biol Med 119:1136-1139, 1965.Crossref
4.
Busfield, D., et al:  An Effect of Phenobarbitone on Blood-Levels of Griseofulvin in Man ,  Lancet 2:1042-1043 ( (Nov 16) ) 1963.Crossref
5.
Cucinell, S.A., et al:  Drug Interactions in Man: I. Effect of Phenobarbital on Plasma Levels of Bishydroxycoumarin (Dicumarol) and Diphenylhydantoin (Dilantin) ,  Clin Pharmacol Ther 6:420-429 ( (July) -Aug) 1965.
6.
Crounse, R.G.:  Effective Use of Griseofulvin ,  Arch Derm 87: 176-178 ( (Feb) ) 1963.Crossref
7.
Bedford, C.; Child, K.J.; and Tomich. E.G.:  Spectrophotofluorometric Assay of Griseofulvin ,  Nature 184 ( (suppl 6) ):364-365, 1959.Crossref
8.
Barnes, M.J.. and Boothroyd, B.:  The Metabolism of Griseofulvin in Mammals ,  Biochem J 78:41-43 ( (Jan) ) 1961.
9.
Burns, J.J., and Conney, A.H.:  Enzyme Stimulation and Inhibition in the Metabolism of Drugs ,  Proc Roy Soc Med 58:955-960 ( (Nov) ) 1965.
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