Warfarin is administered clinically as a racemic mixture of two enantiomers, (R)-warfarin and (S)-warfarin. (S)-Warfarin has more potent anticoagulant activity than (R)-warfarin and is metabolized mainly to (S)-7-hydroxywarfarin by CYP2C9. A simple, rapid, and sensitive high-performance liquid chromatography method with ultraviolet detection was developed for the simultaneous quantitative determination of the (R)- and (S)-enantiomers of warfarin and 7-hydroxywarfarin in human plasma. Analytes and the internal standard (p-chlorowarfarin) were separated using a mobile phase of 0.5% KH2PO4 (pH 3.5)-methanol (41:59, v/v) on a Chiral CD-Ph column at a flow rate of 0.5 mL/min and were detected at a ultraviolet absorbance of 305 nm. Analysis required 200 μL of plasma and involved a simple and rapid solid-phase extraction with an Oasis HLB cartridge, which gave high recovery (greater than 91.8%) and good selectivity for all analytes. The lower limit of quantification for the (R)- and (S)-enantiomers of warfarin and 7-hydroxywarfarin was 2.5 ng/mL for each analyte. Inter- and intraday coefficients of variation for all analytes were less than 14.2% and accuracies were within 6.6% over the linear range. Our results indicate that this method is applicable to the simultaneous monitoring of the enantiomers of warfarin and 7-hydroxywarfarin in human plasma. The S/R-enantiomer ratio of warfarin and the (S)-warfarin/(S)-7-hydroxywarfarin ratio 3 hours after administration in 67 CYP2C9*1/*1 patients ranged from 0.24 to 0.75 and from 1.83 to 19.02, respectively, whereas these ratios in a CYP2C9*3/*3 patient were 1.12 and 17.02, respectively.
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http://dx.doi.org/10.1097/FTD.0b013e31820176d6 | DOI Listing |
PLoS One
December 2024
Department of Forensic Medicine, School of Medicine, Tokyo Women's Medical University, Tokyo, Japan.
Introduction: Traumatic brain injury (TBI) is exacerbated in patients on antithrombotic medications, with warfarin leading to increased bleeding in some cases. However, the extent to which this bleeding increases lethality and its long-term effects remain unclear. This study aimed to investigate the exacerbation of TBI by warfarin treatment and comprehensively evaluate the impact of TBI on the anticoagulant effects of warfarin.
View Article and Find Full Text PDFHeliyon
May 2024
Department of Medicinal Chemistry and Pharmacognosy, Faculty of Pharmacy, Jordan University of Science and Technology, P.O. Box 3030, Irbid, 22110, Jordan.
Warfarin, a widely prescribed anticoagulant, is highly effective for various coagulation disorders. However, its efficacy is limited by a narrow therapeutic index and frequent drug interactions, especially those involving metabolism by Cytochrome P450 (CYP450) enzymes. Piperine, found in black and long pepper, possesses blood-thinning properties and has been observed to inhibit CYP3A and CYP2C enzymes linked to warfarin metabolism.
View Article and Find Full Text PDFSci Rep
September 2022
Liver Engineering Laboratory, Department of Applied Research for Laboratory Animals, Central Institute for Experimental Animals (CIEA), 3-25-12 Tonomachi, Kawasaki-ku, Kawasaki, 210-0821, Japan.
Chimeric TK-NOG mice with a humanized liver (normal Hu-liver) are a unique animal model for predicting drug metabolism in humans. However, residual mouse hepatocytes occasionally prevent the precise evaluation of human drug metabolism. Herein, we developed a novel humanized liver TK-NOG mouse with a conditional knockout of liver-specific cytochrome P450 oxidoreductase (POR cKO Hu-liver).
View Article and Find Full Text PDFFront Pharmacol
January 2022
Department of Biochemistry and Molecular Biology, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, United States.
Coumadin (R/S-warfarin) anticoagulant therapy is highly efficacious in preventing the formation of blood clots; however, significant inter-individual variations in response risks over or under dosing resulting in adverse bleeding events or ineffective therapy, respectively. Levels of pharmacologically active forms of the drug and metabolites depend on a diversity of metabolic pathways. Cytochromes P450 play a major role in oxidizing R- and S-warfarin to 6-, 7-, 8-, 10-, and 4'-hydroxywarfarin, and warfarin alcohols form through a minor metabolic pathway involving reduction at the C11 position.
View Article and Find Full Text PDFCurr Drug Metab
March 2022
Department of Pharmacology, Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Pondicherry, India | Central Inter-Disciplinary Research Facility (CIDRF), Sri Balaji Vidyapeeth University, MGMCRI Campus, Pondicherry, India.
Background: Warfarin is primarily metabolized by cytochrome P450 2C9 (CYP2C9) enzyme, which is encoded by the CYP2C9 gene. CYP2C9*2 and CYP2C9*3 variants significantly influence warfarin metabolism and subsequently the required dose of warfarin.
Objectives: The current retrospective study was aimed to determine the influence of CYP2C9 variants on warfarin metabolic ratio (MR, warfarin/7-hydroxy warfarin) and warfarin maintenance therapy in 210 patients (mean age 44.
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