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CYP2C9 genetic polymorphisms and warfarin.

Andrea R Redman1, Leslie J Dickmann, Robert S Kidd

  • 1Department of Clinical and Administrative Sciences, Mercer University Southern School of Pharmacy, Atlanta, Georgia 30341-4155, USA. Redman_ar@mercer.edu

Clinical and Applied Thrombosis/Hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis
|April 20, 2004
PubMed
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Genetic variations in CYP2C9 impact warfarin metabolism. This study highlights how CYP2C9 genetic polymorphism explains low warfarin dosage needs in two patients, influencing S-warfarin metabolism.

Area of Science:

  • Pharmacogenomics
  • Drug Metabolism

Background:

  • Warfarin is a common anticoagulant with a narrow therapeutic index.
  • CYP2C9 is a key enzyme in warfarin metabolism.
  • Genetic variations in CYP2C9 can significantly alter drug response.

Observation:

  • Two patients with different demographics on low-dose warfarin (10.5 mg and 10 mg weekly) were studied.
  • Both patients possessed at least one variant CYP2C9 allele.
  • Elevated warfarin S:R ratios indicated impaired S-warfarin metabolism in both individuals.

Findings:

  • A CYP2C9*3 heterozygous genotype correlated with low warfarin dosage, consistent with existing literature.
  • A CYP2C9*6 homozygous genotype was reported for the first time in a patient requiring low-dose warfarin.

Related Experiment Videos

  • CYP2C9 genotyping provided a genetic explanation for the patients' reduced warfarin requirements.

    • Implications:

    • CYP2C9 genotyping can explain low warfarin dosage needs in stable patients.
    • Understanding CYP2C9 genotype may aid in optimizing warfarin initiation and dosing.
    • Pharmacogenetic testing can personalize anticoagulant therapy.