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  • Clinically relevant interaction between warfarin and scuppernongs, a quercetin containing muscadine grape: continued questions surrounding flavonoid-induced warfarin interactions

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CASE REPORT
Clinically relevant interaction between warfarin and scuppernongs, a quercetin containing muscadine grape: continued questions surrounding flavonoid-induced warfarin interactions
  1. Christopher J Woodward1,
  2. Zachariah M Deyo2,
  3. Katrina E Donahue3,
  4. Allison M Deal4,
  5. Emily M Hawes2,3
  1. 1UNC Eshelman School of Pharmacy, Chapel Hill, North Carolina, USA
  2. 2University of North Carolina Hospitals and Clinics, Chapel Hill, North Carolina, USA
  3. 3Department of Family Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
  4. 4Lineberger Comprehensive Cancer Center Biostatistics Core, Chapel Hill, North Carolina, USA
  1. Correspondence to Dr Emily M Hawes, ehawes{at}unch.unc.edu

Summary

We present a case of clinically relevant and probable interaction between warfarin and scuppernongs in a 73-year-old woman where ingestion of scuppernongs, a variety of quercetin-containing muscadine grapes, over a period of 2 months was associated with elevations in the International Normalised Ratio to supratherapeutic levels. While muscadine grapes and specifically scuppernongs are found primarily in Southeastern USA, the flavonoid in questionand quercetin is found worldwide as a dietary supplement.

https://doi.org/10.1136/bcr-2013-009608

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