A serious drug interaction leading to spontaneous total hyphema

J Postgrad Med. 2010 Jan-Mar;56(1):46-7. doi: 10.4103/0022-3859.62420.

Abstract

A 70 year-old diabetic man receiving anti-coagulant therapy (Warfarin) for pulmonary embolism secondary to factor V Leiden deficiency, presented to the hospital for chest pain. After initial evaluation, he was started on aspirin (300 mg) and clopidogrel (300 mg). Three days after he was discharged, he presented with preseptal cellulitis complicating left upper eyelid chalazion. Initially, he was treated with several anti-microbial agents used sequentially. Although, the cellulitis resolved, he developed total hyphema of the left eye. The complication seems to have resulted from a complex interaction amongst anti-microbial agents, Warfarin and anti-platelet agents.

MeSH terms

  • Aged
  • Anti-Infective Agents / adverse effects*
  • Anti-Infective Agents / pharmacology
  • Anticoagulants / administration & dosage
  • Aspirin / adverse effects*
  • Aspirin / pharmacology
  • Clopidogrel
  • Drug Interactions
  • Humans
  • Hyphema / chemically induced*
  • Male
  • Platelet Aggregation Inhibitors / adverse effects*
  • Platelet Aggregation Inhibitors / pharmacology
  • Ticlopidine / adverse effects
  • Ticlopidine / analogs & derivatives*
  • Ticlopidine / pharmacology
  • Warfarin / administration & dosage

Substances

  • Anti-Infective Agents
  • Anticoagulants
  • Platelet Aggregation Inhibitors
  • Warfarin
  • Clopidogrel
  • Ticlopidine
  • Aspirin