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Arch Intern Med. 2001;161:1231.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Select anti-infective agents such as co-trimoxazole, metronidazole, select quinolones, macrolides, azole antifungal agents, and isoniazid have been associated with prolonged international normalized ratio and/or bleeding.¹ Few cases have been reported between doxycycline and warfarin.^2-3 We report a case of possible retroperitoneal bleeding associated when these 2 drugs were administered concurrently.

Report of a Case

A 69-year-old white woman presented to the hospital with a 3-day history of left lower quadrant abdominal pain that was progressive, constant, and exacerbated by movement. Six days prior to admission, the patient's physician prescribed 100 mg of oral doxycycline twice daily for 10 days for bronchitis.

The patient's medical history included breast cancer, atrial fibrillation, chronic obstructive pulmonary disease, myocardial infarction, rheumatoid arthritis, osteoporosis, and diverticulosis. Long-term medications included warfarin, diltiazem, atorvastatin, alendronate, albuterol, and fluticasone. One month prior to admission, the international normalized ratio was 2.6.

Vital signs were normal except for a heart rate of 104 beats/min. . . . [Full Text of this Article]

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