Step I Warfarin

[konquer]

How would less stomach acid production affect warfarin concentration?

 

[Richspiders07]

How would less stomach acid production effect warfarin concentration?

are you talking about when using cimetidine?

 

[konquer]

Sort of.
Cimetidine inhibits P450 --> warfarin level would increase. but would the decreased acid production have any effect?

 

[Depakote]

Sort of.
Cimetidine inhibits P450 --> warfarin level would increase. but would the decreased acid production have any effect?

Your big factors with Warfarin are going to be anything that alters cytochrome p450 metabolism or anything that changes vitamin k metabolism (such as abx that wipe out the normal flora).

I don't think a slight increase in stomach pH is going to have nearly as much effect as the cytochrome P450 effect.

 

[Sislo]

How would less stomach acid production affect warfarin concentration?

I think y'all right but what he really means is the acid part of it. I think it has to do with cimetidine mechanism.It is and anti H2 and H2 receptors are on the HCL sectreting cell of the GI and by blocking them with cimetidine, the environment is unfavorable for Warf to kick in

 

[Depakote]

I think y'all right but what he really means is the acid part of it. I think it has to do with cimetidine mechanism.It is and anti H2 and H2 receptors are on the HCL sectreting cell of the GI and by blocking them with cimetidine, the environment is unfavorable for Warf to kick in

But if that was the issue, you'd have less stomach acid, the pills would take longer to dissolve and your issue would be that you'd be seeing less of warfarin's effect due to decreased absorption.

The problem with cimetidine and warfarin is that cimetidine inhibits C-P450, which blocks the metabolism of warfarin and you get a potentiation of warfarin's effects.