An algorithm for managing warfarin resistance

  • Cleve Clin J Med. 2009 Dec;76(12):724-30. doi: 10.3949/ccjm.76a.09062.
Olusegun Osinbowale  1 ,  Monzr Al Malki ,  Andrew Schade ,  John R Bartholomew
Affiliations
  • 1. Department of Cardiovascular Medicine, Section of Vascular Medicine, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
PMID: 19952297 DOI: 10.3949/ccjm.76a.09062
Abstract

Some patients need higher-than-expected doses of warfarin (Coumadin) to get their international normalized ratio (INR) into the therapeutic range. The cause of warfarin resistance can be either acquired (eg, poor compliance, drug interactions, dietary interactions) or hereditary, but the genetic mechanisms of warfarin resistance are not well understood. This review offers an algorithm for the evaluation of patients with suspected warfarin resistance.