The interaction of the prostaglandin E derivative rioprostil with oral anticoagulant agents.

The prostaglandin E1 analogue rioprostil was tested for potential interaction with oral anticoagulant therapy in healthy male volunteers. The effect of rioprostil (0.3 mg, twice a day) was investigated on acenocoumarol (10 mg per subject, n = 7) and phenoprocoumon (0.2 mg/kg, n = 6) single-dose pharmacokinetics and pharmacodynamics. Plasma levels of thrombotest, prothrombin (factor II), and factor VII activities were assayed. Rioprostil, 7 days pretreatment, did not affect control parameters of blood coagulation activity. During the rioprostil period the effect of phenprocoumon on thrombotest and factor VII activities was significantly weaker (p less than 0.02, ANOVA) compared with the control experiment. The effect of acenocoumarol on thrombotest activity was significantly weaker at 24 and 31 hours. None of the pharmacokinetic parameters tested were affected by rioprostil medication. The findings suggest that prostaglandins, at least those of the E series, attenuate the anticoagulant action of the oral anticoagulant agents by a mechanism not related to any pharmacokinetic interaction.