A Man Who Takes 26 Warfarin Pills a Day! A Case Study on Warfarin Resistance

Hossein Karballaei  Mirzahosseini; Leili  Manafi

doi:10.18502/aacc.v12i4.21805

Hossein Karballaei Mirzahosseini Department of Clinical Pharmacy, School of Pharmacy Semnan University of Medical Science, Semnan, Iran.
Leili Manafi Department of Clinical Pharmacy, Kosar Hospital, Semnan, Semnan University of Medical Sciences, Semnan, Iran.

DOI: https://doi.org/10.18502/aacc.v12i4.21805

Keywords: Warfarin resistance; Polymorphism; Vitamin K antagonists

Abstract

In certain patients, particularly those receiving mechanical aortic valve replacement, warfarin is the sole permitted anticoagulant. Some individuals exhibit resistance to warfarin for a variety of reasons, necessitating extremely high and occasionally fatal doses of the medication for their survival. This report details a patient who demonstrates warfarin resistance and investigates the fundamental causes of this phenomenon. The case report emphasizes the possible role of genetic polymorphism in elucidating the mechanisms behind warfarin resistance.