설명
Semaglutide slows gastric emptying, potentially reducing and delaying oral warfarin absorption, leading to variable changes in INR that complicate anticoagulation management.
기전
GLP-1 receptor agonists reduce gastric emptying rate by up to 35%; slower absorption of warfarin can reduce peak plasma concentrations and shift the time-to-peak, altering the pharmacokinetic profile without necessarily changing total AUC predictably.
임상적 중요성
Clinical pharmacokinetic studies with semaglutide demonstrated modest changes in warfarin Cmax; however, INR fluctuation has been reported and warfarin has a narrow therapeutic index.
관리 방법
Monitor INR more frequently when initiating, dose-escalating, or discontinuing semaglutide; adjust warfarin dose based on INR response; educate patient on consistent dietary vitamin K intake.