Vitamin K: a practical guide to the dietary management of patients on warfarin

Warfarin has been successfully used in the medical management of thromboembolic disease for nearly six decades. It is widely assumed that a dietary vitamin K-warfarin interaction exists. To avoid this potential interference with the efficacy of warfarin in stable anticoagulation, patients typically...

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Bibliographic Details
Published in:	Nutrition reviews Vol. 57; no. 9; pp. 288 - 296
Main Authors:	Booth, S.L, Centurelli, M.A
Format:	Journal Article
Language:	English
Published:	Oxford, UK Blackwell Publishing Ltd 01-09-1999 International Life Sciences Institute
Subjects:	Anticoagulants - pharmacology Biological and medical sciences Diet Drug Interactions Food Analysis food composition food composition tables guidelines Humans Medical sciences Miscellaneous nutrient content nutrient intake nutrient-drug interactions Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) Vitamin K - administration & dosage Vitamin K - analysis Vitamin K - therapeutic use vitamin k compounds warfarin Warfarin - pharmacology Human Warfarin Coumarine derivatives Molecular interaction Handbook Feeding Antagonism Clinical management Diet therapy Diet Chemical composition Food Vitamin K
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Summary:	Warfarin has been successfully used in the medical management of thromboembolic disease for nearly six decades. It is widely assumed that a dietary vitamin K-warfarin interaction exists. To avoid this potential interference with the efficacy of warfarin in stable anticoagulation, patients typically receive instructions to consume a constant dietary intake of vitamin K. While dark, green vegetables are primary sources of dietary vitamin K, these foods are not commonly consumed on a daily basis in the United States. However, there still exists dietary resistance to warfarin that is attributable to vitamin K. Based on food analysis studies on vitamin K, it is now known that dietary vitamin K is found in certain plant oils and prepared foods containing these plant oils, such as baked goods, margarines, and salad dressings. The preparation of foods with vitamin K-rich oils may also contribute to a diet-warfarin interaction, although this has yet to be confirmed in a clinical trial. A dose-response of vitamin K on the effect of warfarin anti-coagulation has not yet been established. However, there are sufficient data to suggest that a constant dietary intake of vitamin K that meets current dietary recommendations of 65-80 microgram/day is the most acceptable practice for patients on wafarin therapy. Vitamin K composition data for commonly consumed foods are now available and may facilitate successful anticoagulation for patients being treated with warfarin.
Bibliography:	ArticleID:NURE288 istex:51A6008CF42E7178274E93214A2C2AE07654402C ark:/67375/WNG-3QL8Q3V6-P
ISSN:	0029-6643 1753-4887
DOI:	10.1111/j.1753-4887.1999.tb01815.x