Marcoumar

Marcoumar is a brand name for the oral anticoagulant warfarin potassium. Warfarin and Marcoumar belong to the coumarin anticoagulants, a class of vitamin K antagonists that reduce the synthesis of vitamin K–dependent clotting factors II, VII, IX, and X, as well as proteins C and S. By limiting these factors, warfarin lowers the blood’s tendency to form clots. The effect of warfarin is highly variable between individuals and can be influenced by diet, other medications, and genetic factors, so dosing must be tailored and monitored with the international normalized ratio (INR).

Marcoumar is used to prevent and treat thromboembolic events in adults. Common indications include reducing the risk of stroke in nonvalvular atrial fibrillation, treatment and prevention of deep vein thrombosis and pulmonary embolism, and prevention of systemic embolism in patients with mechanical heart valves. In some situations, warfarin therapy is bridged with heparin or another anticoagulant. Warfarin is typically contraindicated in pregnant women and requires careful management in patients with liver disease or a tendency toward bleeding.

Safety and monitoring are central to therapy with Marcoumar. The major risk is bleeding, which can be serious or life-threatening. Adverse effects include easy bruising, nosebleeds, and gum bleeding. Warfarin has numerous drug interactions (antibiotics, antifungals, antifolate drugs, and many others) and dietary interactions, particularly with foods high in vitamin K. Overdose is treated with vitamin K and, in severe cases, rapid reversal strategies. Warfarin’s pharmacokinetics are primarily hepatic, and dosing is adjusted based on INR values to maintain a target therapeutic range specific to the condition being treated. Brand names and formulations vary by country; in the United States, warfarin is marketed as Coumadin and Jantoven, with other brands including Marcoumar in different regions.