*2.1.1.2. Indications*

Warfarin is prescribed for the treatment and prophylaxis of various thromboembolic diseases such as atrial fibrillation (AF), deep venous thrombosis (DVT), transient ischemic attacks (TIA), pulmonary embolism, and other thromboembolic disorders that may affect carriers of cardiac valvular prosthesis or patients who underwent electric cardioversion [3, 4]. The dose-response relationship of warfarin is influenced by genetic and environmental factors, including mutations in gene coding for cytochrome P (CYP) 450, the hepatic enzyme responsible for oxidative metabolism of warfarin, mutations in gene coding for VKOR [5], concomitant drugs, diet, and various disease states [6]. Although warfarin and other dicumarol derivatives cross the placenta and contribute to fetal bone and central nervous system abnormalities when mothers are treated with warfarin within the first-trimester of pregnancy, there is no evidence that warfarin directly affects bone metabolism when administered to children or adults [7]. Women who will be managed with therapeutic anticoagulation in pregnancy should be treated preferably with a parenteral agent, such as heparin and low-molecular-weight heparin (LMWH), unfractionated heparin (UFH), and fondaparinux [8].
