Description
Warfarin is an orally available antithrombotic commonly used for preventing blood clot formation and migration. The S enantiomer of warfarin is somewhat more potent than the R enantiomer. This coumarin inhibits the subunit 1 of the vitamin K epoxide reductase complex (VKORC1), depleting the reduced form of vitamin K (KH2) and inhibiting the formation of coagulation factors II, VII, IX, and X. Warfarin has a relatively slow onset and requires 1 to 2 days to take effect. This compound is highly sensitive to a wide variety of genetic polymorphisms and is metabolized by cytochrome P4502C9; it also interacts with many other medications and foods, requiring diligent activity monitoring.