Warfarin Drug Interactions: Strategies to Minimize Adverse Drug Events

Warfarin is an oral anticoagulant that requires international normalized ratio (INR) monitoring to assess its safety and efficacy and to facilitate dosage adjustments. It is metabolized primarily by CYP2C9 and has a narrow therapeutic index. Warfarin is prone to drug interactions, given its pharmacokinetic and pharmacodynamic properties. Changes in concomitant medications can cause INR fluctuations, particularly if medications are cytochrome P450 inhibitors or inducers. The unpredictability of the extent and duration of an interaction's effect make it challenging to manage, as represented in this case report. Providers are encouraged to adopt strategies to identify potential drug interactions and minimize the risks of adverse outcomes.