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Warfarin has a narrow therapeutic window and a large variation in dose requirements from one patient to another. Selection of initial and maintenance doses of warfarin therapy is usually based on subjective estimates of patient age, size, nutritional status and organ function.
Genetic guided warfarin dosing could benefit patients initiating warfarin therapy. The FDA revised the labeling on warfarin in February 2010, providing genotype-specific ranges of doses and suggesting that genotypes be taken into consideration when the drug is prescribed. Read the new labeling on warfarin.
However, current recommendations ADVISE AGAINST ROUTINE PHARMACOGENETIC TESTING to guide warfarin dosing as there is insufficient data indicating benefit.
Evidence-Based Management of Anticoagulant Therapy.Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest 2012;141;e152S-e184S.
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