What is "warfarin"

1950, from WARF, acronym from Wisconsin Alumni Research Foundation + -arin, from Coumarin. The organization describes itself as "an independent, nonprofit foundation chartered to support research at the U[niversity of] W[isconsin]-Madison and the designated technology transfer organization for the university."

n. (context pharmaceutical drug English) An anticoagulant medication that is used for the prophylaxis of thrombosis and embolism in many disorders.

n. an anticoagulant (trade name Coumadin) use to prevent and treat a thrombus or embolus [syn: Coumadin]

Warfarin, also known by the brand names Coumadin among others, is an anticoagulant normally used in the prevention of thrombosis and thromboembolism, the formation of blood clots in the blood vessels and their migration elsewhere in the body, respectively. It was initially introduced in 1948 as a pesticide against rats and mice, and is still used for this purpose, although more potent poisons such as brodifacoum have since been developed. In the early 1950s, warfarin was found to be effective and relatively safe for preventing thrombosis and thromboembolism in many disorders. It was approved for use as a medication in 1954, and has remained popular ever since. Warfarin is the most widely prescribed oral anticoagulant drug in North America.

Despite its effectiveness, treatment with warfarin has several shortcomings. Many commonly used medications interact with warfarin, as do some foods (particularly leaf vegetable foods or "greens," since these typically contain large amounts of vitamin K) and its activity has to be monitored by blood testing for the international normalized ratio (INR) to ensure an adequate yet safe dose is taken. A high INR predisposes patients to an increased risk of bleeding, while an INR below the therapeutic target indicates the dose of warfarin is insufficient to protect against thromboembolic events.

Warfarin and related 4-hydroxycoumarin-containing molecules decrease blood coagulation by inhibiting vitamin K epoxide reductase, an enzyme that recycles oxidized vitamin K to its reduced form after it has participated in the carboxylation of several blood coagulation proteins, mainly prothrombin and factor VII. Despite being labeled a vitamin K antagonist, warfarin does not antagonize the action of vitamin K, but rather antagonizes vitamin K recycling, depleting active vitamin K. Thus, the pharmacologic action may always be reversed by fresh vitamin K. When administered, these drugs do not anticoagulate blood immediately. Instead, onset of their effect requires about two to three days before remaining active clotting factors have had time to naturally disappear in metabolism, and the duration of action of a single dose of warfarin is 2 to 5 days. Reversal of warfarin's effect by discontinuing its use, or by administering vitamin K, requires a similar period of time.

Warfarin is a synthetic derivative of dicoumarol, a 4-hydroxycoumarin-derived mycotoxin anticoagulant originally discovered in spoiled sweet clover-based animal feeds. Dicoumarol, in turn, is derived from coumarin, a sweet-smelling but coagulation-inactive chemical found naturally in "sweet" clover (to which it gives its odor and name), tonka beans (also known as "cumaru" from which coumarin's name derives), and many other plants. The name 'warfarin' stems from its discovery at the University of Wisconsin, incorporating the acronym for the organization that funded the key research, "WARF" for the Wisconsin Alumni Research Foundation and the ending "-arin", indicating its link with coumarin.