What is the most common adverse effect associated with exposure to coumarin?
Although rare, hepatotoxicity is the most common adverse effect associated with coumarin exposure in humans. The clinical course typically includes elevations in transaminases that improve with cessation of coumarin exposure. Based on animal models, this may be related to the production of o-hydroxyacetaldehyde which is a toxic metabolite not typically produced in humans. Unlike 4-hydroxycoumarins, coumarin does not possess anticoagulant properties. Although it has been previously implicated in skin irritation, this is more likely related to coumarin derivatives rather than coumarin itself.
Andréjak M et al. French pharmacovigilance survey evaluating the hepatic toxicity of coumarin. Pharmacoepidemiol Drug Saf. 1998; 7 Suppl 1:S45-50.
Submitted by: Willie Eggleston, PharmD, DABAT