Drug breakdown: warfarin
Abstract
In this column, Sharon Rees aims to refresh knowledge and interest in some of the commonly used drugs in a series of tweets. This month she is talking about #warfarin
Dr Sharon Rees @reesprescribe In the 1940s, after mouldy sweet clover led to haemorrhage in cattle, the cause was discovered to be a coumarin. It was used as rodenticide until licensed for human use in 1954 by Wisconsin Alumni Res Foundation (WARF), where it was launched as WARFarin #prescribing
Dr Sharon Rees @reesprescribe Until recently, #warfarin was the main oral anticoagulant in the world. New oral anticoagulants (NOACs) (eg dabigatran) introduced in 2008 have replaced #warfarin for some conditions, but #warfarin is still in use for original indications, including venous thromboembolism treatment and prevention, prophylaxis of embolism, atrial fibrillation, prosthetic heart valve and transient ischemic attacks #prescribing
Dr Sharon Rees @reesprescribe Vitamin K is needed to form many clotting factors. As vitamin K is recycled, it requires conversion back to its reduced active form. #Warfarin competes at vitamin K reductase binding site, so less active form is produced, lowering levels of factors II, VII, IX and X and proteins C and S, prolonging clotting time #prescribing
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