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Stop taking warfarin? No way!

Amit K Verma and Ajai K Verma
Med J Aust 2009; 191 (10): . || doi: 10.5694/j.1326-5377.2009.tb03325.x
Published online: 16 November 2009

To the Editor: Brukner’s personal perspective in a recent issue of the Journal highlights the inherent difficulty of managing patients taking warfarin.1 Although Brukner advocates life-long warfarin therapy for patients who have experienced a pulmonary embolism, we believe few clinicians would be willing to expose their patients to the increased risk of haemorrhage associated with long-term warfarin therapy, especially if a transient risk factor for venous thromboembolism (VTE) existed (such as frequent air travel, in Brukner’s case).


  • Monash University, Melbourne, VIC.


Correspondence: amit_verma5@hotmail.com

  • 1. Brukner PD. Stop taking warfarin? No way! Med J Aust 2009; 190: 704. <MJA full text>
  • 2. Martin JH. Pharmacogenetics of warfarin — is testing clinically indicated? Aust Prescr 2009; 32: 76-80.
  • 3. Taube J, Halsall D, Baglin T. Influence of cytochrome P-450 CYP2C9 polymorphisms on warfarin sensitivity and risk of over-anticoagulation in patients on long-term treatment. Blood 2000; 96: 1816-1819.
  • 4. Bodin L, Verstuyft C, Tregouet DA, et al. Cytochrome P450 2C9 (CYP2C9) and vitamin K epoxide reductase (VKORC1) genotypes as determinants of acenocoumarol sensitivity. Blood 2005; 106: 135-140.
  • 5. Sconce EA, Khan TI, Wynne HA, et al. The impact of CYP2C9 and VKORC1 genetic polymorphism and patient characteristics upon warfarin dose requirements: proposal for a new dosing regimen. Blood 2005; 106: 2329-2333.

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