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Warfarin interacts with many commonly used drugs, and the metabolism of warfarin varies greatly between patients. [27] Some foods have also been reported to interact with warfarin. [27] Apart from the metabolic interactions, highly protein bound drugs can displace warfarin from serum albumin and cause an increase in the INR. [63]
Direct factor Xa inhibitors can be considered as an alternative to warfarin, particularly if a person is on several other medications that interact with warfarin, or if attending medical appointments and laboratory monitoring becomes difficult. [8]
They are categorised as "first-generation" anticoagulants, and have similar effects as warfarin. They have been largely superseded by second-generation anticoagulants because warfarin-resistant rodents have become more common. [6] Anisindione, fluindione, and phenindione are oral anticoagulant medicines with actions similar to warfarin. However ...
For example, warfarin, a commonly-used anticoagulant drug in atrial fibrillation, is metabolised by an enzyme called CYP2C9. Phenytoin, a CYP2C9 inducer, would increase its activity and the rate of warfarin breakdown, thereby reducing its efficacy. [23] Patients should avoid the co-administration of warfarin and phenytoin.
With the growing number of patients taking oral anticoagulation therapy, studies into reversal agents are gaining increasing interest due to major bleeding events and the need for urgent anticoagulant reversal therapy. [112] Reversal agents for warfarin are more widely studied, and established guidelines for reversal exist due to a longer ...
[9] [11] It may also be used for reversal of warfarin therapy. [11] It is given by slow injection into a vein. [9] Another product, activated prothrombin complex concentrate or FEIBA (Factor Eight Inhibitor Bypassing Agent), may be used for acquired hemophilia. [12] Common side effects include allergic reactions, headache, vomiting, and sleepiness.
The European Society of Cardiology (ESC), [21] and National Institute for Health and Care Excellence (NICE) [23] guidelines recommend that if the patient has a CHA 2 DS 2-VASc score of 2 and above, oral anticoagulation therapy (OAC) with a vitamin K antagonist (VKA, e.g. warfarin with target INR of 2-3) or one of the direct oral anticoagulant ...
Type A: augmented pharmacological effects, which are dose-dependent and predictable [5]; Type A reactions, which constitute approximately 80% of adverse drug reactions, are usually a consequence of the drug's primary pharmacological effect (e.g., bleeding when using the anticoagulant warfarin) or a low therapeutic index of the drug (e.g., nausea from digoxin), and they are therefore predictable.