MDElliottMD: home-claude category backfill (parser-claude gap closure)

2026-05-23T10:43:33Z

home-claude category backfill (parser-claude gap closure)

← Older revision		Revision as of 10:43, 23 May 2026
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	== References ==		== References ==
	<references />		<references />
			[[Category:Anticoagulants]]
			[[Category:Vitamin K antagonists]]

MDElliottMD: parser-claude batch MedTemplate pre-fill, Top 300 #116

2026-05-23T03:46:16Z

parser-claude batch MedTemplate pre-fill, Top 300 #116

New page

{{MedTemplate
| generic = Warfarin
| brand = Coumadin (discontinued in US but name in common use), Jantoven
| structure =
| classes = [[:Category:Anticoagulants|Anticoagulant]], [[:Category:Vitamin_K_antagonists|Vitamin K antagonist]]
| uses = <vote slug="mechanical-heart-valve-use">Mechanical heart valves</vote>, <vote slug="aps-use">Antiphospholipid syndrome thromboprophylaxis</vote>, <vote slug="aaf-stroke-prevention-valve-use">Atrial fibrillation with mitral stenosis or mechanical valves</vote>, <vote slug="vte-treatment-use">VTE treatment and secondary prevention</vote>, <vote slug="ckd5-vte-use">VTE in advanced CKD (DOACs less established)</vote>
| starting_dose = Typical 5 mg PO daily; 2.5 mg in elderly, low body weight, malnutrition, hepatic dysfunction. Genotype-guided initial dosing per CPIC/IWPC algorithms (CYP2C9, VKORC1, CYP4F2) is one of the most-established PGx applications in current practice
| preparations = 1, 2, 2.5, 3, 4, 5, 6, 7.5, 10 mg tablets (color-coded by strength)
| fda_max = No fixed maximum; titrated to INR target
| pill_id =
| routes = Oral, IV (rarely used; same dose)
| onset = Anticoagulant effect at 24-72 hours; full INR effect 5-7 days
| duration = 2-5 days after stopping (factor II resynthesis-limited)
| halflife = 36-42 hours (R/S enantiomers differ; S-warfarin is 2-5× more potent and cleared by CYP2C9)<ref name="coumadin-label">FDA Prescribing Information, Coumadin (warfarin sodium), Bristol-Myers Squibb, current revision. https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/009218s108lbl.pdf</ref>
| bioavailability = ~100% (oral)<ref name="coumadin-label" />
| pregnancy = '''Contraindicated in pregnancy''' (warfarin embryopathy, fetal hemorrhage) except in mechanical mitral valves where the maternal mortality of alternative agents may exceed fetal risk.{{citation needed}}
| legal = [[USLegal:Prescription only|Rx-only]] in US
| mechanism = <vote slug="warfarin-mech-claim">Warfarin inhibits vitamin K epoxide reductase complex 1 (VKORC1), preventing regeneration of reduced vitamin K and γ-carboxylation of glutamate residues on factors II, VII, IX, X, and proteins C and S; the result is hypofunctional clotting factors, the most clinically important being factor II (prothrombin, half-life ~60 hours) whose depletion drives the steady-state anticoagulant effect.</vote> CYP2C9 (S-warfarin clearance) and VKORC1 (drug target) polymorphisms together explain 30-50% of inter-individual dosing variance and are the prototype pharmacogenomic target in clinical use<ref name="cpic-warfarin">CPIC Guideline for CYP2C9, VKORC1, CYP4F2, and Warfarin, 2017. https://cpicpgx.org/guidelines/guideline-for-warfarin-and-cyp2c9-and-vkorc1/</ref>. Reversal: vitamin K, 4F-PCC for life-threatening bleeding (FFP if PCC unavailable).
}}

== References ==
<references />

Warfarin - Revision history

MDElliottMD: home-claude category backfill (parser-claude gap closure)

MDElliottMD: parser-claude batch MedTemplate pre-fill, Top 300 #116