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Sex, age (years) | Product, dosage, and indication | Concomitant medications and notes | Adverse drug reaction, time to onset, and Naranjo score | Action taken and outcome |
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F, 45 | Camellia sinensis, Malva sylvestris, Elettaria cardamomum, Hibiscus sabdariffa (THERMOJETICS, Herbalife International of America, Inc Los Angeles, CA), 3 g/day; weight loss diet | Acenocoumarol 14 mg/w (since 10 years) | Reduction of anticoagulant therapy efficacy INR 1.4; 16 days; Possible [4] | Herbal drugs withdrawn, Acenocoumarol dosage increase (16 mg/w); completely recovered |
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F, 70 | Aloe barbadensis, honey, alcohol beverage, herbal liquid home-made preparation, 3 spoons/day; constipation | Warfarin 5 mg/w (since 10 years) | Reduction of anticoagulant therapy efficacy INR 1.42; 2 weeks; Possible [3] | Herbal drug withdrawn, warfarin dosage increase (6.25 mg/w); completely recovered |
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F, 81 | Panax Ginseng (Red Ginseng), dosage not reported; tiredness and dizziness | Acenocoumarol 7 mg/w | Reduction of anticoagulant therapy efficacy INR 0.99; Possible [4] | Herbal drugs withdrawn, Acenocoumarol dosage increase (08 mg/w); completely recovered |
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M, 70 | Fermented Papaya Preparation (IMMUN'AGE FPP, Osato international, Gifu, Japan), 3 g/day orally; ageing prevention | Warfarin 25 mg/w (since 9 years) | Reduction of anticoagulant therapy efficacy INR 1.64; 1 month; Probable [8] | Herbal drug withdrawn, warfarin dosage increase (27.5 mg/w); completely recovered |
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F, 80 | Vaccinium myrtillus (BILBERRY JUICE, Sottobosco Paoli, Civezzano, Italy), 200 ml/day; indication not reported | Warfarin 27.5 mg/w (since 1.5 year) | Reduction of anticoagulant therapy efficacy INR 1.6; 4 days; Possible [4] | Herbal drug withdrawn, warfarin dosage increase (32.5 mg/w); completely recovered |
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F, 63 | Spirea ulmaria, Taraxacum officinale, Sambucus nigra, Betula alba, Urtica dioica, Cynara scolymus, Amarena, Ttriticum repens, Tilia cordata (AFFILINE, Nahrin AG, Saren, Switzerland), 1 spoon/day and Spirulina maxima, Urtica Dioica, Papaya extract (LINPHACELL Nahrin AG, Saren, Switzerland), 4 tablets/day; weight loss diet | Acenocoumarol 20 mg/w (since 2 years) | Reduction of anticoagulant therapy efficacy INR 1.37; 1 month; Possible [2] | Herbal drugs withdrawn, Acenocoumarol dosage increase (22 mg/w); improvement |
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M, 79 | vitamins (C,E), fish oil, lutein, zeaxantin, minerals (PRESERVISION 3, Bausch & Lomb incorporated Rochester, NY), 1 capsule/day; macular degeneration | Acenocoumarol 11 mg/w (since 15 years) | Reduction of anticoagulant therapy efficacy INR 1.50; 6 days; Possible [3] | Supplement withdrawn, Acenocoumarol dosage increase (12 mg/w); improvement |
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