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Doctors consider many factors before blood-thinning medication is prescribed, but some clues are hidden. And now, it is becoming more common to have a gene test before you get your Coumadin.
After surgery to replace a heart valve, Robert McNeilly started taking the blood-thinner Warfarin. "When they said, 'You know, this is rat poison, don't you?' I said, 'Well are you sure it's safe for me to take?'" said McNeilly. All joking aside, the medicine requires regular follow ups.
Like Robert, many use blood-thinners without a problem. But, genetic variants can change the way the drug is metabolized.
Doctor Dan Roden says, “If you have one variant, you might be down to 4-½ milligrams a day. If you have a more serious variant, you might be down to 4 milligrams a day. But if you have two serious variants, you might be down to 1 milligram a day." This sort of genetic quirk can be dangerous.
"Now this is a drug that it makes a big difference if your target dose is 1 milligram and you take 5 milligrams - you've way overdosed yourself,” says Doctor Roden.
Tests are no approved to detect Warfarin-sensitivity, but they aren’t widely available.
For the time being, doctor Roden says standard practice will continue, taking us all forward into the world of genetically personalized medicine.
The doctor says the problems associated with genetic variants and blood-thinner medication becomes obvious within a few weeks. Usually during this time period, a patient is under close supervision, so complications are noticed right away.
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