bromfenacoum and coumarin

Treatment with coumarin derivatives is highly individualised due to high intra- and inter-individual variation in dose response and risks of severe bleeding or thromboembolic complications. Treatment focuses on reaching and maintaining a stable target international normalised ratio (INR). However, unexpected INRs that are not explained by noncompliance or vitamin K intake may occur. Here we describe seven cases of unexpected INRs, and provide clues that clarify the underlying mechanism.

Topics: 4-Hydroxycoumarins; Adolescent; Adult; Aged; Aged, 80 and over; Anticoagulants; Aryl Hydrocarbon Hydroxylases; Coumarins; Cytochrome P-450 CYP2C9; Drug Interactions; Female; Genetic Variation; Humans; International Normalized Ratio; Male; Medication Adherence; Middle Aged; Mixed Function Oxygenases; Risk Factors; Vitamin K Epoxide Reductases; Young Adult