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Substituting Warfarin Products: What's the Source of the Problem?
MedLine Citation:
PMID:  21666090     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Many clinicians have expressed concerns about the bioequivalence of warfarin products, and data suggest that substituting warfarin products may increase the risk of major bleeding and thromboembolic complications. Anecdotal reports and some retrospective studies have reported differences in anticoagulation control after a warfarin product substitution. But the best available evidence-prospective, randomized, blinded clinical trials-has failed to validate these observations. Indeed, interpatient and intrapatient variability in anticoagulation control observed before and after warfarin product substitution is very similar. So, while differences in product standardization, bioavailability, and bioequivalence make a convenient explanation, the problem lies elsewhere. Perhaps poor communication, fractionated systems of care, and errors are the culprits.
Authors:
Stuart T Haines
Publication Detail:
Type:  Journal Article     Date:  2011-06-10
Journal Detail:
Title:  The Annals of pharmacotherapy     Volume:  45     ISSN:  1542-6270     ISO Abbreviation:  Ann Pharmacother     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-06-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9203131     Medline TA:  Ann Pharmacother     Country:  United States    
Other Details:
Languages:  eng     Pagination:  807-9     Citation Subset:  IM    
Affiliation:
Department of Pharmacy Practice and Science, School of Pharmacy, University of Maryland, Baltimore, MD.
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