Minor
Probable
Descripción
Omeprazole may modestly increase warfarin plasma concentrations through weak CYP2C19 inhibition; the clinical effect is generally small but warrants awareness.
Mecanismo
Omeprazole inhibits CYP2C19, the minor pathway for R-warfarin metabolism, causing a slight reduction in warfarin clearance.
Relevancia clínica
The magnitude of INR change is typically minor (<10%) and rarely requires dose adjustment; however, sensitive patients may experience larger effects.
Manejo clínico
No routine dose adjustment needed; monitor INR if omeprazole dose changes or if patient is a CYP2C19 poor metabolizer.