A case report of overt bleeding in a young woman on warfarin given the anabolic steroid danazol for menorrhagia is reported. This interaction appears to be poorly recognised and we suggest that when commencing such a treatment the dose of anticoagulant should initially be halved and thereafter tailored to the thrombotest.
Koch-WeserJSellersEM. Drug interactions with coumarin anticoagulants. N Engl J Med1971; 285:547–558.
2.
HowardCWHansonSGWahedMA. Anabolic steroids and anticoagulants. Br Med J1977; 1:1659–60.
3.
GoulbourneJAMacLeodDAD. An interaction between danazol and warfarin. Br J Obstet Gynaecol1981; 88:950–951.
4.
ChimbiraTHCopeEAndersonABMBoltonFG. The effect of danazol on menorrhagia, coagulation mechanisms, haematological indices and body weight. Br J Obstet Gynaecol1979; 86:46–50.
5.
LaurellCBRannevikG. A comparison of plasma protein changes induced by danazol, pregnancy and oestrogens. J Clin Endocrinol Metab1979; 49:719–725.
6.
BarbosaJSealUSDoeRP. Effects of anabolic steroids on haptoglobin, orosomucoid, plasminogen, fibrinogen, transferrin, ceruloplasmin, α1-anti-trypsin. ß-glucuronidase and total serum proteins. J Clin Endocrinol Metab1971; 33:388.
