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Pharmacogenomics Aspect of Warfarin Therapy
Book chapter

Pharmacogenomics Aspect of Warfarin Therapy

Matthew D Krasowski
Pharmacogenomics in Clinical Therapeutics, pp.26-38
John Wiley & Sons, Ltd
02/03/2012
DOI: 10.1002/9781119959601.ch3

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Abstract

Warfarin is a commonly used oral anticoagulant that has a narrow therapeutic index and wide interindividual variability in dose requirements. The most common serious adverse effect for warfarin is hemorrhage. Genetic variation in cytochrome P450 2C9 (major enzyme metabolizing warfarin) and vitamin K epoxide reductase (molecular target of warfarin) are responsible for a significant fraction of variability in warfarin therapeutic dosing. Evidence from clinical trials has demonstrated that pharmacogenetic information can be combined with other variables to better predict warfarin maintenance dose and reduce adverse effects, although there is still uncertainty whether pharmacogenetic‐guided strategies actually improve patient outcomes and reduce health care costs. Overall, pharmacogenomics approaches offer the promise of reducing adverse events in patients on warfarin therapy.
cytochrome P450 enzyme system drug interactions hemorrhage pharmacogenetics vitamin K

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