U.S. Department of Health & Human Services Divider Arrow National Institutes of Health Divider Arrow NCATS

Details

Stereochemistry RACEMIC
Molecular Formula C19H15O4.Na
Molecular Weight 330.3098
Optical Activity ( + / - )
Defined Stereocenters 0 / 1
E/Z Centers 0
Charge 0

SHOW SMILES / InChI
Structure of WARFARIN SODIUM

SMILES

[Na+].CC(=O)CC(C1=CC=CC=C1)C2=C([O-])C3=CC=CC=C3OC2=O

InChI

InChIKey=KYITYFHKDODNCQ-UHFFFAOYSA-M
InChI=1S/C19H16O4.Na/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;/q;+1/p-1

HIDE SMILES / InChI

Molecular Formula C19H15O4
Molecular Weight 307.32
Charge -1
Count
Stereochemistry RACEMIC
Additional Stereochemistry No
Defined Stereocenters 0 / 1
E/Z Centers 0
Optical Activity ( + / - )

Molecular Formula Na
Molecular Weight 22.9898
Charge 1
Count
Stereochemistry ACHIRAL
Additional Stereochemistry No
Defined Stereocenters 0 / 0
E/Z Centers 0
Optical Activity NONE

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%.

Approval Year

TargetsConditions

Conditions

ConditionModalityTargetsHighest PhaseProduct
Primary
COUMADIN

Approved Use

Warfarin 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 Date

1954
Preventing
COUMADIN

Approved Use

Warfarin 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 Date

1954
Preventing
COUMADIN

Approved Use

Warfarin 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 Date

1954
Cmax

Cmax

ValueDoseCo-administeredAnalytePopulation
2186 ng/mL
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

AUC

ValueDoseCo-administeredAnalytePopulation
52278 ng × h/mL
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

T1/2

ValueDoseCo-administeredAnalytePopulation
32.4 h
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
7 day
single, oral
WARFARIN unknown
Homo sapiens
population: UNHEALTHY
age: UNKNOWN
sex: UNKNOWN
food status: UNKNOWN
Funbound

Funbound

ValueDoseCo-administeredAnalytePopulation
1%
single, oral
WARFARIN unknown
Homo sapiens
population: UNHEALTHY
age: UNKNOWN
sex: UNKNOWN
food status: UNKNOWN
Doses

Doses

DosePopulationAdverse events​
125 mg single, oral
Overdose
Dose: 125 mg
Route: oral
Route: single
Dose: 125 mg
Co-administed with::
oxycodone, p.o(200 mg, single)
Sources: Page: p.718
unhealthy, 43
n = 1
Health Status: unhealthy
Condition: Deep venous thromboses
Age Group: 43
Sex: M
Population Size: 1
Sources: Page: p.718
Disc. AE: Vomiting, Loss of consciousness...
AEs leading to
discontinuation/dose reduction:
Vomiting
Loss of consciousness
Sources: Page: p.718
150 mg single, oral
Overdose
Dose: 150 mg
Route: oral
Route: single
Dose: 150 mg
Co-administed with::
chlorpromazine, p.o(3 g, single)
Sources: Page: p.718
unhealthy, 44
n = 1
Health Status: unhealthy
Condition: Aortic valve replacement
Age Group: 44
Sex: M
Population Size: 1
Sources: Page: p.718
Disc. AE: Drowsiness...
AEs leading to
discontinuation/dose reduction:
Drowsiness
Sources: Page: p.718
540 mg single, oral
Overdose
Dose: 540 mg
Route: oral
Route: single
Dose: 540 mg
Co-administed with::
clonazepam, p.o(4 mg, single)
Sources: Page: p.1
healthy, 59
n = 1
Health Status: healthy
Age Group: 59
Sex: F
Population Size: 1
Sources: Page: p.1
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: Page: p.1
unhealthy, 64
n = 1
Health Status: unhealthy
Condition: Cardiomyopathy |Atrial fibrillation
Age Group: 64
Sex: M
Population Size: 1
Sources: Page: p.1
Disc. AE: Hemoptysis, Hematuria...
AEs leading to
discontinuation/dose reduction:
Hemoptysis
Hematuria
Dyspnea
Cough
Sources: Page: p.1
10 mg 1 times / day multiple, oral (max)
Recommended
Dose: 10 mg, 1 times / day
Route: oral
Route: multiple
Dose: 10 mg, 1 times / day
Sources: Page: p.1
unhealthy
Health Status: unhealthy
Condition: Venous thrombosis|Atrial fibrillation|Myocardial infarction
Sources: Page: p.1
Disc. AE: Bleeding...
AEs leading to
discontinuation/dose reduction:
Bleeding (grade 5)
Sources: Page: p.1
AEs

AEs

AESignificanceDosePopulation
Loss of consciousness Disc. AE
125 mg single, oral
Overdose
Dose: 125 mg
Route: oral
Route: single
Dose: 125 mg
Co-administed with::
oxycodone, p.o(200 mg, single)
Sources: Page: p.718
unhealthy, 43
n = 1
Health Status: unhealthy
Condition: Deep venous thromboses
Age Group: 43
Sex: M
Population Size: 1
Sources: Page: p.718
Vomiting Disc. AE
125 mg single, oral
Overdose
Dose: 125 mg
Route: oral
Route: single
Dose: 125 mg
Co-administed with::
oxycodone, p.o(200 mg, single)
Sources: Page: p.718
unhealthy, 43
n = 1
Health Status: unhealthy
Condition: Deep venous thromboses
Age Group: 43
Sex: M
Population Size: 1
Sources: Page: p.718
Drowsiness Disc. AE
150 mg single, oral
Overdose
Dose: 150 mg
Route: oral
Route: single
Dose: 150 mg
Co-administed with::
chlorpromazine, p.o(3 g, single)
Sources: Page: p.718
unhealthy, 44
n = 1
Health Status: unhealthy
Condition: Aortic valve replacement
Age Group: 44
Sex: M
Population Size: 1
Sources: Page: p.718
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: Page: p.1
unhealthy, 64
n = 1
Health Status: unhealthy
Condition: Cardiomyopathy |Atrial fibrillation
Age Group: 64
Sex: M
Population Size: 1
Sources: Page: p.1
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: Page: p.1
unhealthy, 64
n = 1
Health Status: unhealthy
Condition: Cardiomyopathy |Atrial fibrillation
Age Group: 64
Sex: M
Population Size: 1
Sources: Page: p.1
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: Page: p.1
unhealthy, 64
n = 1
Health Status: unhealthy
Condition: Cardiomyopathy |Atrial fibrillation
Age Group: 64
Sex: M
Population Size: 1
Sources: Page: p.1
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: Page: p.1
unhealthy, 64
n = 1
Health Status: unhealthy
Condition: Cardiomyopathy |Atrial fibrillation
Age Group: 64
Sex: M
Population Size: 1
Sources: Page: p.1
Bleeding grade 5
Disc. AE
10 mg 1 times / day multiple, oral (max)
Recommended
Dose: 10 mg, 1 times / day
Route: oral
Route: multiple
Dose: 10 mg, 1 times / day
Sources: Page: p.1
unhealthy
Health Status: unhealthy
Condition: Venous thrombosis|Atrial fibrillation|Myocardial infarction
Sources: Page: p.1
Overview

Overview

CYP3A4CYP2C9CYP2D6hERG



OverviewOther

Other InhibitorOther SubstrateOther Inducer




Drug as perpetrator​

Drug as perpetrator​

TargetModalityActivityMetaboliteClinical evidence
yes [Ki 8 uM]
Drug as victim

Drug as victim

TargetModalityActivityMetaboliteClinical evidence
yes
yes
yes
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
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
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
Sourcing

Sourcing

Vendor/AggregatorIDURL
PubMed

PubMed

TitleDatePubMed
Unexplained thrombosis in HIV-infected patients receiving protease inhibitors: report of seven cases.
1999 Dec
Increased risk of intracranial hemorrhage when aspirin is combined with warfarin: A meta-analysis and hypothesis.
1999 Jul-Aug
Bleeding during warfarin and aspirin therapy in patients with atrial fibrillation: the AFASAK 2 study. Atrial Fibrillation Aspirin and Anticoagulation.
1999 Jun 28
[Marked creatine-phosphokinase elevation in myopathy after treatment with bezafibrate].
2000 Sep
Management of intracranial bleeding associated with anticoagulation: balancing the risk of further bleeding against thromboembolism from prosthetic heart valves.
2000 Sep
Abdominal wall hematoma as a complication of warfarinization.
2001 Apr
Spontaneous subcapsular renal hematoma secondary to anticoagulant therapy.
2001 Apr
Behçet's disease with a large intracardiac thrombus: a case report.
2001 Apr
Perioperative management and reversal of antithrombotic therapy.
2001 Feb
Thrombolysis and antithrombotic therapy for coronary artery disease.
2001 Feb
Oral anticoagulants. Pharmacologic issues for use in the elderly.
2001 Feb
Endovascular caval interruption in pregnant patients with deep vein thrombosis of the lower extremity.
2001 Feb
Systematic review of long term anticoagulation or antiplatelet treatment in patients with non-rheumatic atrial fibrillation.
2001 Feb 10
Anticoagulant pharmacodynamics of tinzaparin following 175 iu/kg subcutaneous administration to healthy volunteers.
2001 Feb 15
Central venous device-related infection and thrombosis in patients treated with moderate dose continuous-infusion interleukin-2.
2001 Feb 15
What is the best emergency treatment for children who ingest warfarin rodenticide?
2001 Feb 5
Regarding postoperative stroke after warfarin for cutaneous surgery.
2001 Jan
Effect of regimen complexity on patient satisfaction and compliance with warfarin therapy.
2001 Jan
Anticoagulation and heart failure.
2001 Jan
Sneddon's syndrome: a case report.
2001 Mar
Palliative care for the elderly.
2001 Mar
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
Atrial fibrillation and stroke : concepts and controversies.
2001 Mar
Mutations of the CYP2C9 gene and the response to warfarin.
2001 Mar
What is the optimal medical management of ischemic heart failure?
2001 Mar-Apr
Patents

Sample Use Guides

In Vivo Use Guide
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
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
by admin
on Fri Dec 15 15:06:25 GMT 2023
Edited
by admin
on Fri Dec 15 15:06:25 GMT 2023
Record UNII
6153CWM0CL
Record Status Validated (UNII)
Record Version
  • Download
Name Type Language
WARFARIN SODIUM
EP   MART.   ORANGE BOOK   USP   VANDF   WHO-DD   WHO-IP  
Common Name English
WARFARIN SODIUM [USP MONOGRAPH]
Common Name English
WARFARIN SODIUM [VANDF]
Common Name English
SODIUM WARFARIN
Common Name English
WARFARIN SODIUM [ORANGE BOOK]
Common Name English
COUMADIN
Brand Name English
JANTOVEN
Brand Name English
2H-1-BENZOPYRAN-2-ONE, 4-HYDROXY-3-(3-OXO-1-PHENYLBUTYL)-, SODIUM SALT
Common Name English
WARFARIN SODIUM SALT [MI]
Common Name English
Warfarin sodium [WHO-DD]
Common Name English
ZOOCOUMARIN SODIUM SALT
Common Name English
WARFARIN SODIUM [WHO-IP]
Common Name English
WARFARIN SODIUM [MART.]
Common Name English
PROTHROMADIN
Common Name English
ALDOCUMAR
Common Name English
3-(α-Acetonylbenzyl)-4-hydroxycoumarin sodium salt
Common Name English
APO-WARFARIN
Brand Name English
WARFARIN SODIUM SALT
MI  
Common Name English
WARFARIN SODIUM [EP MONOGRAPH]
Common Name English
ATHROMBIN
Brand Name English
WARFARINUM NATRICUM [WHO-IP LATIN]
Common Name English
Classification Tree Code System Code
NCI_THESAURUS C45597
Created by admin on Fri Dec 15 15:06:25 GMT 2023 , Edited by admin on Fri Dec 15 15:06:25 GMT 2023
EPA PESTICIDE CODE 86003
Created by admin on Fri Dec 15 15:06:25 GMT 2023 , Edited by admin on Fri Dec 15 15:06:25 GMT 2023
NCI_THESAURUS C263
Created by admin on Fri Dec 15 15:06:25 GMT 2023 , Edited by admin on Fri Dec 15 15:06:25 GMT 2023
Code System Code Type Description
SMS_ID
100000092049
Created by admin on Fri Dec 15 15:06:25 GMT 2023 , Edited by admin on Fri Dec 15 15:06:25 GMT 2023
PRIMARY
CAS
129-06-6
Created by admin on Fri Dec 15 15:06:25 GMT 2023 , Edited by admin on Fri Dec 15 15:06:25 GMT 2023
PRIMARY
ECHA (EC/EINECS)
204-929-4
Created by admin on Fri Dec 15 15:06:25 GMT 2023 , Edited by admin on Fri Dec 15 15:06:25 GMT 2023
PRIMARY
EVMPD
SUB05128MIG
Created by admin on Fri Dec 15 15:06:25 GMT 2023 , Edited by admin on Fri Dec 15 15:06:25 GMT 2023
PRIMARY
ALANWOOD
warfarin-sodium
Created by admin on Fri Dec 15 15:06:25 GMT 2023 , Edited by admin on Fri Dec 15 15:06:25 GMT 2023
PRIMARY
PUBCHEM
16204922
Created by admin on Fri Dec 15 15:06:25 GMT 2023 , Edited by admin on Fri Dec 15 15:06:25 GMT 2023
PRIMARY
NCI_THESAURUS
C1658
Created by admin on Fri Dec 15 15:06:25 GMT 2023 , Edited by admin on Fri Dec 15 15:06:25 GMT 2023
PRIMARY
CHEBI
10034
Created by admin on Fri Dec 15 15:06:25 GMT 2023 , Edited by admin on Fri Dec 15 15:06:25 GMT 2023
PRIMARY
WHO INTERNATIONAL PHARMACOPEIA
WARFARIN SODIUM
Created by admin on Fri Dec 15 15:06:25 GMT 2023 , Edited by admin on Fri Dec 15 15:06:25 GMT 2023
PRIMARY Description: A white, amorphous or crystalline powder; odourless. Solubility: Soluble in less than 1 part of water and in ethanol (~750 g/l) TS; slightly soluble in ether R. Category: Anticoagulant. Storage: Warfarin sodium should be kept in a well-closed container, protected from light. Labelling: The designation on the container of Warfarin sodium should state whether the substance is in the amorphous or the crystalline, clathrate form. Additional information: Warfarin sodium is discoloured by light. Even in the absence of light, it is gradually degraded on exposureto a humid atmosphere, the decomposition being faster at higher temperatures.Definition: Warfarin sodium contains not less than 98.0% and not more than 102.0% of C19H15NaO4, calculated with reference to the anhydrous and 2-propanol-free substance.
ChEMBL
CHEMBL1464
Created by admin on Fri Dec 15 15:06:25 GMT 2023 , Edited by admin on Fri Dec 15 15:06:25 GMT 2023
PRIMARY
DAILYMED
6153CWM0CL
Created by admin on Fri Dec 15 15:06:25 GMT 2023 , Edited by admin on Fri Dec 15 15:06:25 GMT 2023
PRIMARY
MERCK INDEX
m11506
Created by admin on Fri Dec 15 15:06:25 GMT 2023 , Edited by admin on Fri Dec 15 15:06:25 GMT 2023
PRIMARY Merck Index
EPA CompTox
DTXSID7035010
Created by admin on Fri Dec 15 15:06:25 GMT 2023 , Edited by admin on Fri Dec 15 15:06:25 GMT 2023
PRIMARY
DRUG BANK
DBSALT000278
Created by admin on Fri Dec 15 15:06:25 GMT 2023 , Edited by admin on Fri Dec 15 15:06:25 GMT 2023
PRIMARY
FDA UNII
6153CWM0CL
Created by admin on Fri Dec 15 15:06:25 GMT 2023 , Edited by admin on Fri Dec 15 15:06:25 GMT 2023
PRIMARY
RXCUI
114194
Created by admin on Fri Dec 15 15:06:25 GMT 2023 , Edited by admin on Fri Dec 15 15:06:25 GMT 2023
PRIMARY RxNorm
Related Record Type Details
SOLVATE->ANHYDROUS
BASIS OF STRENGTH->SUBSTANCE
ASSAY (HPLC)
USP
PARENT -> SALT/SOLVATE
BASIS OF STRENGTH->SUBSTANCE
ASSAY (UV)
EP
SOLVATE->ANHYDROUS
Related Record Type Details
IMPURITY -> PARENT
CHROMATOGRAPHIC PURITY (HPLC/UV)
USP
IMPURITY -> PARENT
correction factors: for the calculation of content, multiply the peak areas of the following impurities by the corresponding correction factor: impurity C = 0.4
CHROMATOGRAPHIC PURITY (HPLC/UV)
EP
IMPURITY -> PARENT
CHROMATOGRAPHIC PURITY (HPLC/UV)
USP
IMPURITY -> PARENT
correction factors: for the calculation of content, multiply the peak areas of the following impurity by the corresponding correction factor: impurity B = 0.5
CHROMATOGRAPHIC PURITY (HPLC/UV)
EP
IMPURITY -> PARENT
UNSPECIFIED
CHROMATOGRAPHIC PURITY (HPLC/UV)
EP
Related Record Type Details
ACTIVE MOIETY