Response to warfarin and other oral anticoagulants: effects of disease states.

Abstract

BACKGROUND: Warfarin is associated with numerous drug and food interactions, and much attention has been appropriately focused on this subject. Because several disease states may also affect response to oral anticoagulants, we present a summary of the literature. METHODS: We searched MEDLINE for original articles on the effect of disease states on response to warfarin. RESULTS: Liver disease and thyroid dysfunction are well-documented as affecting warfarin response. Further study is needed to establish whether febrile illness, congestive heart failure, and other disease states enhance the effect of warfarin in some patients. CONCLUSION: Careful monitoring of anticoagulant therapy in patients with diseases that have the potential to affect warfarin response could increase safety and efficacy of this important agent.