Small molecule
PubChem CID 54678486
Warfarin
Coumadin
- Mechanism of action
- Vitamin K epoxide reductase inhibitor
- In plain language
- Blocks the liver enzyme that recycles vitamin K, which the body needs to make key blood-clotting proteins, so clots form more slowly.
- How it works
- Warfarin inhibits the vitamin K epoxide reductase complex 1 (VKORC1), blocking the regeneration of reduced vitamin K required for gamma-carboxylation of clotting factors II, VII, IX, and X, as well as the anticoagulant proteins C and S. Because it does not affect already-circulating clotting factors, its anticoagulant effect is delayed, with onset around 24 hours but peak effect at 72-96 hours. Genetic variation in CYP2C9 and VKORC1 contributes to significant interpatient dosing variability, and therapeutic effect is monitored via INR due to its narrow therapeutic index.
- Therapeutic applications
- Indicated for prophylaxis and treatment of venous thrombosis and pulmonary embolism; prophylaxis and treatment of thromboembolic complications associated with atrial fibrillation and/or cardiac valve replacement; and reduction in risk of death, recurrent myocardial infarction, and thromboembolic events following myocardial infarction.
- Class
- Small molecule
- Therapeutic area
- Anticoagulant
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