Acenocoumarol as an alternative anticoagulant in a patient with warfarin‐related nephropathy.

Adverse Event: Warfarin‐related nephropathy. Drug Implicated: Warfarin. The Patient: A 31‐year‐old female, managed with warfarin for rheumatic heart disease with atrial fibrillation. Evidence that Links the Drug to the Event: There were no alternative causes of nephropathy that could have caused the adverse event in this patient. Management: Shifting the drug from warfarin to acenocoumarol. Mechanism: Difference in renal elimination between warfarin and acenocoumarol. Implication for Therapy: Clinicians should be aware of this rare adverse effect of warfarin, and acenocoumarol can be considered as an alternative therapy for this condition. Hypotheses to be Tested: Further prospectively designed studies are needed to consider acenocoumarol as an alternative therapy in warfarin‐related nephropathy. [ABSTRACT FROM AUTHOR]