state of his condition and denied taking any additional medication
or a change in diet or lifestyle; however, he indicated that he had
consumed 20 ml of Gouqizi wine in the evening on November 9
on the advice of a friend as he was suffering from blurred vision.
Although the patient was aware that the wine could influence the
therapeutic effect of warfarin, he had previously consumed 60 ml
of wine (not containing Gouqizi) and not experienced any negative
effects.
Application of the Naranjo Adverse Drug Reaction (ADR) Scale
[11] indicated a probable relationship (score of 6) between the elevated
INR with hematuria and the patient’s concomitant use of
warfarin and Gouqizi. The patient was advised to discontinue the
use of Gouqizi wine and to abstain from warfarin for 2 days. On the
morning of November 11, the patient continued to see blood in the
urine, with diminished color intensity; by the evening, the hematuria
had resolved. On November 12, the patient’s INR was 2.12 and
urine test results were normal with a urinary red blood cell count
of 11/l. He continued warfarin at a daily dose of 1.875 mg and the
INR was found to be 2.0 after 1 week (T