Genetic (or factors or variants) mechanisms for sensitivity to the anticoagulant Warfarin

Warfarin has been the mainstay of anticoagulation therapy for more than 50 years. Despite its proven efficacy and low cost, the clinical response to this agent is not predictable and the management of warfarin therapy is challenging because of the large variability in dose requirements and its side effects. Sensitivity to warfarin appears to be multifactorial and polygenic phenomenon. Genetic polymorphisms especially in CYP2C9 and VKORC1 in combination appear to have a major influence on sensitivity to warfarin. Age, sex, weight, disease state, diet, concomitant medications and ethnic affect sensitivity to warfarin. Despite to all limitations because of being multifactor sensitivity to warfarin, prospective studies of genotyping for CYP2C9 and VKORC1 of patients taking warfarin has the clear potential to determine the clinical safe dose of warfarin according to these genetic factors is a practicable goal and set a promising example of personalized medicine. Genetic and non genetic factors affecting sensitivity to warfarin are noticed in this article.