Warfarin-flucloxacillin interaction presenting as cardioembolic ischemic stroke.

摘要

Both warfarin and flucloxacillin are frequently prescribed medications which have the potential to have life threatening interactions. We describe a case of sub-therapeutic anti-coagulation following a course of oral flucloxacillin, resulting in an ischemic stroke. A 68-year-old female on long term anti-coagulation for atrial fibrillation presented with an acute left hemiparesis. International normalised ratio (INR) was 1.4 in the emergency department. She had commenced a 14-day course of oral flucloxacillin 500 mg qid and oral phenoxymethylpenicillin 999 mg qid for a soft tissue infection of her foot 17 days prior to admission. The most recent INR taken 19 days prior to admission was 3.5.