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  • Title: A case report of a patient carrying CYP2C9*3/4 genotype with extremely low warfarin dose requirement.
    Author: Lee SY, Nam MH, Kim JS, Kim JW.
    Journal: J Korean Med Sci; 2007 Jun; 22(3):557-9. PubMed ID: 17596671.
    Abstract:
    We report a case of intolerance to warfarin dosing due to impaired drug metabolism in a patient with CYP2C9*3/*4. A 73-yr-old woman with atrial fibrilation was taking warfarin. She attained a high prothrombin time international normalized ratio (INR) at the standard doses during the induction of anticoagulation and extremely low dose of warfarin (6.5 mg/week) was finally chosen to reach the target INR. Genotyping for CYP2C9 revealed that this patient had a genotype CYP2C9*3/*4. This is the first Korean compound heterozygote for CYP2C9*3 and *4. This case suggests the clinical usefulness of pharmacogenetic testing for individualized dosage adjustments of warfarin.
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