Warfarin and its interactions with foods, herbs and other dietary supplements

Nutescu, Edith A.; Shapiro, Nancy L.; Ibrahim, Sonia; West, Patricia M.

doi:10.1517/14740338.5.3.433

Cited by 126 publications

(90 citation statements)

References 108 publications

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“…Processed foods and fast foods can be significant sources of vitamin K because of the oils used to produce them. 99 Soybean oil used in fast food restaurants may contain as much as 193 μg vitamin K/100 g of oil. According to the US Department of Agriculture, a cup of raw spinach contains 144.9 μg vitamin K, whereas a cup of frozen spinach that has been cooked has 1027.3 μg vitamin K. The fat substitute Olestra is found in many snack foods.…”

Section: Food and Drug Interactionsmentioning

confidence: 99%

See 1 more Smart Citation

Prevention and Treatment of Thrombosis in Pediatric and Congenital Heart Disease

Giglia¹,

Massicotte²,

Tweddell³

et al. 2013

Circulation

298

245

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Section: Food and Drug Interactionsmentioning

confidence: 99%

“…Olestra potato chips were cited in 1 source to contain 347 μg vitamin K/100 g chips. 99 From this information, families can be taught to change their cooking oil, to use fresh instead of frozen green vegetables, to read snack food labels, and to cut down on the amount of fast food eaten each week.…”

Section: Food and Drug Interactionsmentioning

confidence: 99%

Prevention and Treatment of Thrombosis in Pediatric and Congenital Heart Disease

Giglia¹,

Massicotte²,

Tweddell³

et al. 2013

Circulation

298

245

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“…A randomised, open-label, controlled study of newly diagnosed ischaemic stroke patients (n = 35) found that two weeks of concomitant use of Panax ginseng extract 1.5 g with warfarin did not significantly affect peak values, INR and PT area under the curve, thus concluding that Panax ginseng did not influence the pharmacological action of warfarin. (27) (9,10) In vitro study (34,36) Animal study (35) Clinical study (11) -CYP1A1, 2C6, 2C11 inhibitor (35) -Displaces warfarin from HSA-warfarin (36) -Antiplatelet effect (34) -Coumarin-containing (33) Clinical study (37) Animal study (38) -CYP3A4 inducer (37) -CYP1A, 2C, 3A inducer (38) Ginkgo Ginkgo biloba Leaf: 银杏; Fruit: 白果 Case report (12,13) In vitro study (41,42) Clinical study (39) -Antiplatelet effect (39) -CYP1A2, 2C9, 2C19, 2E1, 3A4 inhibitor (41,42) Animal study (43) -CYP1A1, CYP1A2, CYP2B, CYP2C, CYP3A inducer (43) Clinical study (14,15,40) In vitro study (44) Dong quai Angelica sinensis Root: 当归 Case report (16) Animal study (45) -Coumarin-containing (33) ---…”

Section: Asian Ginseng 人参 (Panax Ginseng)mentioning

confidence: 99%

“…Pharmacodynamic: Danshen contains coumarin derivatives, (33) and has been found to exhibit antiplatelet effects by inhibiting platelet aggregation using platelet cAMP. (34) Pharmacokinetic: In vitro studies have found that tanshinones in danshen inhibit CYP1A1, 2C6 and 2C11-mediated warfarin metabolism, and that sodium tanshinone IIA sulfonate replaces warfarin from the binding site on human serum albumin-warfarin complex, increasing free warfarin concentration in blood.…”

Section: Mechanism Of Interaction: Danshen On Warfarinmentioning

confidence: 99%

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Interaction between warfarin and Chinese herbal medicines

Chua¹,

Ang²,

Zhong³

et al. 2015

smedj

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In traditional Chinese medicine (TCM), the human body is divided into Yin and Yang. Diseases occur when the Yin and Yang balance is disrupted. Different herbs are used to restore this balance, achieving the goal of treatment. However, inherent difficulties in designing experimental trials have left much of TCM yet to be substantiated by science. Despite that, TCM not only remains a popular form of medical treatment among the Chinese, but is also gaining popularity in the West. This phenomenon has brought along with it increasing reports on herb-drug interactions, beckoning the attention of Western physicians, who will find it increasingly difficult to ignore the impact of TCM on Western therapies. This paper aims to facilitate the education of Western physicians on common Chinese herbs and raise awareness about potential interactions between these herbs and warfarin, a drug that is especially susceptible to herb-drug interactions due to its narrow therapeutic range.

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Anticoagulants

Henry

Desai

2010

Burger's Medicinal Chemistry and Drug Discovery

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Thrombotic disorders are a major cause of morbidity and mortality in humans. Examples of thrombotic disorders include pulmonary embolism, deep vein thrombosis, disseminated intravascular coagulation, acute myocardial infarction, unstable angina, and cerebrovascular thrombosis. Anticoagulants are the mainstay of treatment and prevention of these disorders. The most widely used anticoagulants include unfractionated heparin, low molecular weight heparins and warfarin. Newer agents introduced in the past decade include bivalirudin, fondaparinux, and argatroban. Mechanistically, these anticoagulants either directly inhibit thrombin or indirectly reduce the activity of thrombin and factor Xa. Several new molecules have been recently designed to directly inhibit thrombin and factor Xa with high potency and considerable selectivity, of which dabigatran and rivaroxaban were approved for clinical use in few countries in 2008. Molecules being pursued in clinical trials include AZD0837, LB‐30870, otamixaban, apixaban, YM‐150, and others. Ximelagatran, which was introduced in 2004 as a direct thrombin inhibitor, was taken off the market within 20 months due to significant hepatotoxicity. Indirect anticoagulants utilize the antithrombin‐mediated conformational activation and bridging mechanisms for inhibiting coagulation enzymes. Among the indirect anticoagulants that are currently being investigated in clinical trials are a biotinylated idraparinux and SR123781. Over the last two decades, major conceptual strides have been made including the design of the first anticoagulant based solely on factor Xa inhibition (fondaparinux) and the establishment of the paradigm that anticoagulation is possible without frequent laboratory monitoring (ximelagatran). Current work attempts to establish other concepts such as the dual inhibition of free and clot‐bound thrombin by a heparin‐based molecule (ORG42675) and the applicability of neutral P1‐group containing active site‐directed molecules as effective inhibitors of coagulation enzymes (rivaroxaban). To date, no molecule has been designed that satisfies all the properties of an ideal anticoagulant including a broad therapeutic window, absence of bleeding risk, no requirement for frequent coagulation monitoring, oral bioavailability, availability of an effective antidote, lack of hepatoxicity and absence other adverse effects. Yet, the newer agents are likely to be more attractive than the heparin‐ and coumarin‐based therapy. In this chapter, we review the structure, design, and mechanism of action of clinically used and new potential anticoagulants. Special emphasis is placed on the molecular interaction of anticoagulants with their targets.

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Warfarin and its interactions with foods, herbs and other dietary supplements

Cited by 126 publications

References 108 publications

Prevention and Treatment of Thrombosis in Pediatric and Congenital Heart Disease

Prevention and Treatment of Thrombosis in Pediatric and Congenital Heart Disease

Interaction between warfarin and Chinese herbal medicines

Anticoagulants

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