Details
Stereochemistry | RACEMIC |
Molecular Formula | C19H16O4 |
Molecular Weight | 308.3279 |
Optical Activity | ( + / - ) |
Defined Stereocenters | 0 / 1 |
E/Z Centers | 0 |
Charge | 0 |
SHOW SMILES / InChI
SMILES
CC(=O)CC(C1=CC=CC=C1)C2=C(O)C3=C(OC2=O)C=CC=C3
InChI
InChIKey=PJVWKTKQMONHTI-UHFFFAOYSA-N
InChI=1S/C19H16O4/c1-12(20)11-15(13-7-3-2-4-8-13)17-18(21)14-9-5-6-10-16(14)23-19(17)22/h2-10,15,21H,11H2,1H3
Molecular Formula | C19H16O4 |
Molecular Weight | 308.3279 |
Charge | 0 |
Count |
|
Stereochemistry | RACEMIC |
Additional Stereochemistry | No |
Defined Stereocenters | 0 / 1 |
E/Z Centers | 0 |
Optical Activity | ( + / - ) |
Warfarin is an anticoagulant drug normally used to prevent blood clot formation as well as migration. Warfarin is marketed under the brand name Coumadin among others. Coumadin (crystalline warfarin sodium) is an anticoagulant which acts by inhibiting vitamin
K-dependent coagulation factors. Chemically, it is 3-(α-acetonylbenzyl)-4-hydroxycoumarin and is a racemic mixture of the R- and S-enantiomers. Coumadin is indicated for the prophylaxis and/or treatment of venous thrombosis and its extension, and pulmonary embolism. It is also indicated for the prophylaxis and/or treatment of the thromboembolic
complications associated with atrial fibrillation and/or cardiac valve replacement. Warfarin is thought to interfere with clotting factor synthesis by inhibition of the C1 subunit of the vitamin K epoxide reductase (VKORC1) enzyme complex, thereby reducing the regeneration of vitamin K1 epoxide. The degree of depression is dependent upon the dosage
administered and, in part, by the patient’s VKORC1 genotype. Therapeutic doses of warfarin decrease the total amount of the active form of each vitamin K dependent clotting factor made by the liver by approximately 30% to 50%.
CNS Activity
Originator
Approval Year
Targets
Primary Target | Pharmacology | Condition | Potency |
---|---|---|---|
24.7 nM [IC50] |
Conditions
Condition | Modality | Targets | Highest Phase | Product |
---|---|---|---|---|
Primary | COUMADIN Approved UseWarfarin sodium tablets are indicated for the prophylaxis and/or treatment of venous thrombosis and its extension, and pulmonary embolism. Warfarin sodium tablets are indicated for the prophylaxis and/or treatment of the thromboembolic complications associated with atrial fibrillation and/or cardiac valve replacement. Warfarin sodium tablets are indicated to reduce the risk of death, recurrent myocardial infarction, and thromboembolic events such as stroke or systemic embolization after myocardial infarction. Launch Date1954 |
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Preventing | COUMADIN Approved UseWarfarin sodium tablets are indicated for the prophylaxis and/or treatment of venous thrombosis and its extension, and pulmonary embolism. Warfarin sodium tablets are indicated for the prophylaxis and/or treatment of the thromboembolic complications associated with atrial fibrillation and/or cardiac valve replacement. Warfarin sodium tablets are indicated to reduce the risk of death, recurrent myocardial infarction, and thromboembolic events such as stroke or systemic embolization after myocardial infarction. Launch Date1954 |
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Preventing | COUMADIN Approved UseWarfarin sodium tablets are indicated for the prophylaxis and/or treatment of venous thrombosis and its extension, and pulmonary embolism. Warfarin sodium tablets are indicated for the prophylaxis and/or treatment of the thromboembolic complications associated with atrial fibrillation and/or cardiac valve replacement. Warfarin sodium tablets are indicated to reduce the risk of death, recurrent myocardial infarction, and thromboembolic events such as stroke or systemic embolization after myocardial infarction. Launch Date1954 |
Cmax
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
2186 ng/mL EXPERIMENT https://www.ncbi.nlm.nih.gov/pubmed/19552747 |
25 mg single, oral dose: 25 mg route of administration: Oral experiment type: SINGLE co-administered: |
WARFARIN plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
AUC
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
52278 ng × h/mL EXPERIMENT https://www.ncbi.nlm.nih.gov/pubmed/19552747 |
25 mg single, oral dose: 25 mg route of administration: Oral experiment type: SINGLE co-administered: |
WARFARIN plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
T1/2
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
7 day |
single, oral |
WARFARIN plasma | Homo sapiens population: UNHEALTHY age: UNKNOWN sex: UNKNOWN food status: UNKNOWN |
|
32.4 h EXPERIMENT https://www.ncbi.nlm.nih.gov/pubmed/19552747 |
25 mg single, oral dose: 25 mg route of administration: Oral experiment type: SINGLE co-administered: |
WARFARIN plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
Funbound
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
1% |
single, oral |
WARFARIN plasma | Homo sapiens population: UNHEALTHY age: UNKNOWN sex: UNKNOWN food status: UNKNOWN |
Doses
Dose | Population | Adverse events |
---|---|---|
125 mg single, oral Overdose |
unhealthy, 43 |
Disc. AE: Vomiting, Loss of consciousness... AEs leading to discontinuation/dose reduction: Vomiting Sources: Loss of consciousness |
150 mg single, oral Overdose |
unhealthy, 44 |
Disc. AE: Drowsiness... AEs leading to discontinuation/dose reduction: Drowsiness Sources: |
540 mg single, oral Overdose |
healthy, 59 |
|
5 mg 1 times / day multiple, oral Recommended Dose: 5 mg, 1 times / day Route: oral Route: multiple Dose: 5 mg, 1 times / day Sources: |
unhealthy, 64 |
Disc. AE: Hemoptysis, Hematuria... AEs leading to discontinuation/dose reduction: Hemoptysis Sources: Hematuria Dyspnea Cough |
10 mg 1 times / day multiple, oral Recommended Dose: 10 mg, 1 times / day Route: oral Route: multiple Dose: 10 mg, 1 times / day Sources: |
unhealthy Health Status: unhealthy Sources: |
Disc. AE: Bleeding... AEs leading to discontinuation/dose reduction: Bleeding (grade 5) Sources: |
AEs
AE | Significance | Dose | Population |
---|---|---|---|
Loss of consciousness | Disc. AE | 125 mg single, oral Overdose |
unhealthy, 43 |
Vomiting | Disc. AE | 125 mg single, oral Overdose |
unhealthy, 43 |
Drowsiness | Disc. AE | 150 mg single, oral Overdose |
unhealthy, 44 |
Cough | Disc. AE | 5 mg 1 times / day multiple, oral Recommended Dose: 5 mg, 1 times / day Route: oral Route: multiple Dose: 5 mg, 1 times / day Sources: |
unhealthy, 64 |
Dyspnea | Disc. AE | 5 mg 1 times / day multiple, oral Recommended Dose: 5 mg, 1 times / day Route: oral Route: multiple Dose: 5 mg, 1 times / day Sources: |
unhealthy, 64 |
Hematuria | Disc. AE | 5 mg 1 times / day multiple, oral Recommended Dose: 5 mg, 1 times / day Route: oral Route: multiple Dose: 5 mg, 1 times / day Sources: |
unhealthy, 64 |
Hemoptysis | Disc. AE | 5 mg 1 times / day multiple, oral Recommended Dose: 5 mg, 1 times / day Route: oral Route: multiple Dose: 5 mg, 1 times / day Sources: |
unhealthy, 64 |
Bleeding | grade 5 Disc. AE |
10 mg 1 times / day multiple, oral Recommended Dose: 10 mg, 1 times / day Route: oral Route: multiple Dose: 10 mg, 1 times / day Sources: |
unhealthy Health Status: unhealthy Sources: |
Overview
CYP3A4 | CYP2C9 | CYP2D6 | hERG |
---|---|---|---|
OverviewOther
Other Inhibitor | Other Substrate | Other Inducer |
---|---|---|
Drug as perpetrator
Target | Modality | Activity | Metabolite | Clinical evidence |
---|---|---|---|---|
yes [Ki 8 uM] |
Drug as victim
Target | Modality | Activity | Metabolite | Clinical evidence |
---|---|---|---|---|
Page: 14.0 |
yes | |||
Page: 14.0 |
yes | |||
Page: 14.0 |
yes | |||
Page: 14.0 |
yes | likely (co-administration study) Comment: Inhibitors of CYP2C9, 1A2, and/or 3A4 have the potential to increase the effect (increase INR) of warfarin by increasing the exposure of warfarin; Inducers of CYP2C9, 1A2, and/or 3A4 have the potential to decrease the effect (decrease INR) of warfarin by decreasing the exposure of warfarin Page: 14.0 |
||
Page: 14.0 |
yes | likely (co-administration study) Comment: Inhibitors of CYP2C9, 1A2, and/or 3A4 have the potential to increase the effect (increase INR) of warfarin by increasing the exposure of warfarin; Inducers of CYP2C9, 1A2, and/or 3A4 have the potential to decrease the effect (decrease INR) of warfarin by decreasing the exposure of warfarin Page: 14.0 |
||
Page: 14.0 |
yes | yes (pharmacogenomic study) Comment: If the patient’s CYP2C9 and/or VKORC1 genotype are known, consider these ranges in choosing the initial dose. Patients with CYP2C9 *1/*3, *2/*2, *2/*3, and *3/*3 may require more prolonged time (>2 to 4 weeks) to achieve maximum INR effect for a given dosage regimen than patients without these CYP variants; Inhibitors of CYP2C9, 1A2, and/or 3A4 have the potential to increase the effect (increase INR) of warfarin by increasing the exposure of warfarin; Inducers of CYP2C9, 1A2, and/or 3A4 have the potential to decrease the effect (decrease INR) of warfarin by decreasing the exposure of warfarin Page: 14.0 |
PubMed
Title | Date | PubMed |
---|---|---|
Chondrodysplasia punctata and maternal warfarin use during pregnancy. | 1975 Mar |
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Abdominal wall hematoma as a complication of warfarinization. | 2001 Apr |
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Spontaneous subcapsular renal hematoma secondary to anticoagulant therapy. | 2001 Apr |
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Behçet's disease with a large intracardiac thrombus: a case report. | 2001 Apr |
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Perioperative management and reversal of antithrombotic therapy. | 2001 Feb |
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Thrombolysis and antithrombotic therapy for coronary artery disease. | 2001 Feb |
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Antithrombotic therapy in valvular heart disease. | 2001 Feb |
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Oral anticoagulants. Pharmacologic issues for use in the elderly. | 2001 Feb |
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Subtherapeutic INR values associated with a switch to generic warfarin. | 2001 Feb |
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Current trends in the management of deep venous thrombosis and postthrombotic syndrome. | 2001 Feb |
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Implications of cytochrome P450 2C9 polymorphism on warfarin metabolism and dosing. | 2001 Feb |
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Sevelamer hydrochloride (Renagel), a nonabsorbed phosphate-binding polymer, does not interfere with digoxin or warfarin pharmacokinetics. | 2001 Feb |
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Stroke prophylaxis in nonvalvular atrial fibrillation. | 2001 Feb |
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Endovascular caval interruption in pregnant patients with deep vein thrombosis of the lower extremity. | 2001 Feb |
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Heparin and coumadin: delayed postpolypectomy bleeding. | 2001 Feb |
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Asymptomatic atrial fibrillation: problems of management. | 2001 Feb |
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How safely and for how long can warfarin therapy be withheld in prosthetic heart valve patients hospitalized with a major hemorrhage? | 2001 Feb |
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Kidney retransplants after initial graft loss to vascular thrombosis. | 2001 Feb |
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Images in clinical medicine. Retroperitoneal hemorrhage. | 2001 Feb 1 |
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Central venous device-related infection and thrombosis in patients treated with moderate dose continuous-infusion interleukin-2. | 2001 Feb 15 |
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Thrombus formation on atherosclerotic plaques: pathogenesis and clinical consequences. | 2001 Feb 6 |
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[Old adrenal hematoma: a case report]. | 2001 Jan |
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Generic substitution: issues for problematic drugs. | 2001 Jan |
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Regarding clinical practice guidelines on the use of warfarin. | 2001 Jan |
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The sin of omission: a systematic review of antithrombotic therapy to prevent stroke in atrial fibrillation. | 2001 Jan |
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Hypertension due to renal artery occlusion in a patient with antiphospholipid syndrome. | 2001 Jan |
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Cardiac and great vessel thrombosis in Behçet's disease. | 2001 Jan |
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Effect of regimen complexity on patient satisfaction and compliance with warfarin therapy. | 2001 Jan |
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HIV and thrombosis: a review. | 2001 Jan |
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Molecular dynamics study of the IIA binding site in human serum albumin: influence of the protonation state of Lys195 and Lys199. | 2001 Jan 18 |
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Need for increased dose of warfarin in HIV patients taking nevirapine. | 2001 Jan 26 |
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Primary antiphospholipid syndrome masquerading as diabetic retinopathy. | 2001 Jan-Feb |
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Sneddon's syndrome: a case report. | 2001 Mar |
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Long-term results of venous revascularization for Paget-Schroetter syndrome in athletes. | 2001 Mar |
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Prevention, diagnosis, and treatment of venous thromboembolic complications of gynecologic surgery. | 2001 Mar |
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The association of vitamin K status with warfarin sensitivity at the onset of treatment. | 2001 Mar |
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Aspirin does not influence the effect of angiotensin-converting enzyme inhibition on left ventricular ejection fraction 3 months after acute myocardial infarction. | 2001 Mar |
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Hemoptysis in patients with renal insufficiency : the role of flexible bronchoscopy. | 2001 Mar |
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Efficacy and safety of intravenous phytonadione (vitamin K1) in patients on long-term oral anticoagulant therapy. | 2001 Mar |
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Improving medication safety across a multihospital system. | 2001 Mar |
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Potential clinical efficacy and cost benefit of a transesophageal echocardiography-guided low-molecular-weight heparin (enoxaparin) approach to antithrombotic therapy in patients undergoing immediate cardioversion from atrial fibrillation. | 2001 Mar |
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Atrial fibrillation and stroke : concepts and controversies. | 2001 Mar |
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Low-dose warfarin fails to prolong survival of dual lumen venous dialysis catheters. | 2001 Mar |
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Management of thrombosis in women with antiphospholipid syndrome. | 2001 Mar |
|
Adverse reactions to fluoroquinolones. an overview on mechanistic aspects. | 2001 Mar |
|
Profile of moxifloxacin drug interactions. | 2001 Mar 15 |
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Subarachnoid haemorrhage. | 2001 Mar 17 |
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Vitamin K for warfarin-associated coagulopathy. | 2001 Mar 3 |
|
Clinical trials that have influenced the treatment of venous thromboembolism: a historical perspective. | 2001 Mar 6 |
|
What is the optimal medical management of ischemic heart failure? | 2001 Mar-Apr |
Patents
Sample Use Guides
In Vivo Use Guide
Sources: https://www.drugs.com/dosage/warfarin.html
Usual Adult Dose for Prevention of Thromboembolism in Atrial Fibrillation Initial dose: 2 to 5 mg orally once a day
Maintenance dose: 2 to 10 mg orally once a day
Usual Adult Dose for Myocardial Infarction
Initial dose: 2 to 5 mg orally once a day
Maintenance dose: 2 to 10 mg orally once a day
Usual Adult Dose for Deep Vein Thrombosis - Prophylaxis
Initial dose: 2 to 5 mg orally once a day
Maintenance dose: 2 to 10 mg orally once a day
Route of Administration:
Oral
In Vitro Use Guide
Sources: https://www.ncbi.nlm.nih.gov/pubmed/6712738
Curator's Comment: One strain (TAS) is susceptible and two strains (HW and HS) resistant to the anticoagulant and lethal effects of warfarin.
Vitamin K-reductase activity was inhibited by approximately 13 and 8% respectively when microsomal preparations from TAS and HW animals were incubated with 50 uM vitamin K1 and 10 uM warfarin.
Substance Class |
Chemical
Created
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Record UNII |
5Q7ZVV76EI
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Record Status |
Validated (UNII)
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NDF-RT |
N0000175964
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WHO-ATC |
B01AA03
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WHO-VATC |
QB01AA03
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NCI_THESAURUS |
C263
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LIVERTOX |
NBK548837
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NCI_THESAURUS |
C45597
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WHO-ESSENTIAL MEDICINES LIST |
10.2
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NDF-RT |
N0000175476
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EPA PESTICIDE CODE |
86002
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1719000
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C945
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PRIMARY | RxNorm | ||
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WARFARIN
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81-81-2
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Warfarin
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warfarin
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54678486
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201-377-6
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CHEMBL1464
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100000079328
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m11506
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2847
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D014859
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Related Record | Type | Details | ||
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TARGET -> INHIBITOR | |||
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SALT/SOLVATE -> PARENT | |||
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SALT/SOLVATE -> PARENT | |||
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SALT/SOLVATE -> PARENT | |||
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BINDER->LIGAND |
BINDING
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RACEMATE -> ENANTIOMER |
Related Record | Type | Details | ||
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METABOLITE INACTIVE -> PARENT |
metabolism of warfarin include CYP2C9, 2C19, 2C8, 2C18, 1A2, and 3A4. CYP2C9, a polymorphic enzyme, is likely to be the principal form of human liver CYP450 that modulates the in vivo anticoagulant activity of warfarin.
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METABOLITE INACTIVE -> PARENT | |||
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METABOLITE INACTIVE -> PARENT | |||
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METABOLITE INACTIVE -> PARENT |
Formation rate is higher for S isomer; metabolism of warfarin include CYP2C9, 2C19, 2C8, 2C18, 1A2, and 3A4. CYP2C9, a polymorphic enzyme, is likely to be the principal form of human liver CYP450 that modulates the in vivo anticoagulant activity of warfarin.
URINE
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METABOLITE LESS ACTIVE -> PARENT |
by reductases
URINE
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Related Record | Type | Details | ||
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ACTIVE MOIETY |
Name | Property Type | Amount | Referenced Substance | Defining | Parameters | References |
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Biological Half-life | PHARMACOKINETIC |
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Volume of Distribution | PHARMACOKINETIC |
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Tmax | PHARMACOKINETIC |
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Route of Elimination | PHARMACOKINETIC |
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Renal function impairment PHARMACOKINETIC |
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Onset of Action | PHARMACOKINETIC |
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