Various Factors Influencing the Enantiomers of Warfarin Pharmacokinetics: A Systematic Review of Population Pharmacokinetics

Abstract

Warfarin is the most commonly prescribed anti-coagulant medication. Warfarin’s pharmacokinetics (PK) in its enantiomeric form have been reported to be highly variable. Five population pharmacokinetic model studies for warfarin were identified in this systematic review. This review summarized these studies and reported on various factors affecting warfarin PK. Most studies reported a one-compartment model with first-order absorption and elimination for both S-warfarin and R-warfarin. Warfarin disposition has been reported to be influenced by various factors, including gender, age, genetic variation, body surface area (BSA), concurrent drug, weight, and ethnicity. So, all of these factors must be considered when addressing this pharmacokinetic variability. These models should undergo an external evaluation to confirm their generalizability and to support model-informed dosing in clinical settings.