Interaction between warfarin and propranolol.

The interaction between propranolol and warfarin was investigated in six healthy volunteers using a low dose warfarin protocol and in New Zealand white rabbits. Warfarin concentration (Cmin) in the volunteers increased by 14.7% on addition of propranolol (P less than 0.02). There was no significant change in prothrombin time. In the rabbit study, elimination half-life was shorter in the propranolol treated animals (8.20 +/- 0.44 h) than in controls (10.89 +/- 0.62 h). This was due to a fall in its volume of distribution from 1.13 +/- 0.10 1 kg-1 in controls to 0.81 +/- 0.08 1 kg-1 in the propranolol treated group. Clearance was not significantly altered. The small change in warfarin concentration could be of clinical importance in some patients because warfarin has a low therapeutic index. This requires further investigation.