Ciprofloxacin and Warfarin

Abstract
The recent letter by Linville and Matanin (1) brought attention to an interaction between norfloxacin (Noroxin, Merck Sharp & Dohme, West Point, Pennsylvania) and warfarin that resulted in an increased prothrombin time. We would like to report a case of a similar interaction between warfarin and ciprofloxacin (Cipro, Miles Inc., West Haven, Connecticut), another of the fluoroquinolone antibiotics. A 72-year-old white man with end-stage cardiomyopathy and a prosthetic aortic valve who was receiving chronic warfarin therapy was hospitalized with worsening congestive heart failure. He also had gout, type II diabetes mellitus, hypertension, chronic renal insufficiency, and hypothyroidism. In addition to

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