Avaliação da estabilidade de anticoagulação entre a varfarina e a femprocumona

Abstract

Oral anticoagulation has been shown to be effective in the prevention and treatment of thromboembolic events. Vitamin K antagonists (VKA) are the drugs of choice for over 50 years in treatment for prevention of thromboembolic events and the most commonly used are warfarin and phenprocoumon. Currently there are new oral anticoagulants, the direct factor Xa inhibitors, and direct thrombin inhibitors which demonstrate similar efficacy to VKA and low bleeding risk and do not require monitoring because they have low interaction with other drugs and foods. Despite these advantages, the AVK still widely used due to the long experience of its use, the possibility of monitoring through the control of international normalized ratio (INR), the existence of an antidote to reverse its effect (vitamin K) and at low cost . The main difference between the AVK is pharmacological half-life, which is shorter for warfarin, approximately 30 hours versus 216 hours for phenprocoumon. There are few data in the literature that compare the efficacy, stability and drug interactions of these two drugs. Changes in therapeutic levels of AVK and the difficulty of keeping it stable due to interactions with drugs and food is a limiting factor for the efficacy and safety of these drugs. Due to the lack of evidence comparing the stability of the therapeutic level of warfarin and phenprocoumon, it is necessary that studies comparing these two drugs in relation to maintaining therapeutic level of anticoagulation.