Background: warfarin is the most used oral anticoagulant in the world for treating the tromboembolic complications of prophylaxis that come with several cardiovascular diseases. Resistance to this medicine becomes a real health problem for those patients who need it. Objective: to revise the different causes that can have an influence on a greater resistance and sensibility to warfarin. Method: a bibliographic review in Scopus through HInari and in the BVS, in Scielo and in Medline through PubMed, was made. The following descriptors were used: warfarin, anticoagulant, resistance and sensibility, and contraindications. A total of 234 references were obtained; 94 of them were selected for this study. According to the type of reference, they included eight systematic reviews, four controlled clinical trials, and some observational studies and clinical case presentations. A bibliographical list that permitted the annotation of references was created. Development: nowadays, warfarin is the main oral anticoagulant prescribed for the prevention and treatment of tromboembolic disorders in spite of being among the medicaments associate to a high incidence of undesirable effects. The most common and dangerous adverse reaction of warfarin is bleeding which may even be fatal; to this is added the interindividual variability in the response to the treatment; as well as its many pharmacological interactions. All these factors together can make of warfarin a difficult medicine to handle. Conclusions: the high variability of these factors that may interfere with warfarin, make of this medicament one of the most difficult ones to handle. Diet, association with other medicine and the genetic base of the patients are the factors that can mainly intervene in the resistance and sensibility to this medicament.
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