Warfarin – the poison that saves lives

History of the creation of warfarin

The prototype of this drug was discovered in the 1930s, when scientists were trying to find the substance that causes hemorrhagic diathesis in cattle when used of rotten sweet clover, also known as communiga.

Luck smiled on Carl Link in 1936 when he discovered dicoumarol – the product obtained from the oxidation of coumarin. In 1948, the substance Warfarin (WARFARIN) was patented.

Warfarin was supposed to be used as rat poison because the resulting substance was believed to have extremely toxic properties.

But the health-threatening properties of the new substance were not confirmed, and research in the 1950s sparked the interest of clinicians. Since then warfarin has saved thousands of lives.

How does warfarin save lives?

This substance is an anticoagulant, that is, it disrupts the blood’s ability to clot by inhibiting / suppressing / the synthesis of vitamin K in the liver. This property of the preparation ensures the prevention of the formation of thrombi in certain diseases and conditions.

Indications for the appointment of warfarin

The ability of blood to clot is a protective reaction of the body, which prevents its leakage in case of cuts and injuries to the skin surfaces. But in some cases this safety mechanism can cripple and even kill the person.

These are some of those cases:

• Mechanical heart valve prostheses – even the best valves are very different from the tissues of the body, and therefore, in order to prevent the formation of thrombi on the valves, it is necessary to suppress the ability of the blood to clot.

p>

• Atrial fibrillation – atrial fibrillation or complete disruption of the heart rhythm – disorganized contraction of the muscle fibers of the atria increases the risk of blood clots in the left atrial appendage.

• Venous thrombosis – inflammatory or non-inflammatory, increases the risk of thromboembolic complications, the most dangerous of which is thromboembolism of the pulmonary artery.

• Thrombophilia – a disease characterized by increased formation of blood clots.

Choosing an appropriate warfarin dose and regimen

Before starting the treatment, the attending physician determines for each of his patients his international normalized ratio /INR/. This term is important to remember because warfarin dose control is based on the results of this laboratory indicator.

Usually, minimum doses of the preparation are initially prescribed and subsequently the doses are increased if necessary. The attending physician decides on the need to increase the dose of this anticoagulant based on the INR level.

The target level of this indicator depends on the condition that led to the need for the appointment of warfarin. For example, in atrial fibrillation, the target INR range is between 2.0 – 3.0.

After reaching the target level of INR, this indicator is controlled once a month, if there is no need to do this more often. It makes sense to do an unplanned INR control if warfarin from another manufacturer is started.

What do people taking warfarin need to know?

This anticoagulant interacts with both food and medications, resulting in decreased or increased blood coagulation.

And since warfarin inhibits the synthesis of vitamin K in the liver, foods containing large amounts of this nutrient also reduce the effectiveness of the preparation, and these are the following foods:

• Cabbage;
• Lettuce;
• Cucumber;
• Soy;
• Mayonnaise;
• Coffee;