Sunday, September 24, 2023

Genetic Changes Affecting the Pharmacokinetics of Warfarin Dosing

  • Polymorphisms in P450 CYP2C9*2 and CYP2C9*3 Hepatic Microsomal Enzyme System
    • ↓ metabolism of warfarin
    • ↓ warfarin dose requirements
    • ↑ INR levels at a given dose
    • ↑ risk for bleeding during warfarin therapy

  • Duplication or Multiplication of Cyt P450 Enzyme Genes (P450 CYP2D6 & CYP2A6 )
    • ↑ metabolic clearance of Warfarin 
    • Subtherapeutic INR 
  • Missense mutations of VKORC1 gene
    • Warfarin resistance
  • Polymorphisms in VKORC1 gene
    • Inter-individual variability in the dose-anticoagulant effect of warfarin


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