I Do Not Want That Rat Poison!

by Busola Akinbote, PharmD

Busola Akinbote, PharmD, is a clinical pharmacist specialist at the Atlanta VAMC in Carrollton, Georgia.

“I do not want you treating me with that rat poison!” If you have heard these words come out of your patient’s mouth, then you have dealt with warfarin or its brand equivalent. Warfarin is a special medication because it has a narrow therapeutic index. Warfarin therapy must be monitored closely and adjusted to balance the risk of bleeds against the benefits of protection against blood clots.

In the December 2012 issue of Federal Practitioner, my colleagues Renee Smith, PharmD, Dr. William H. Replogle, and I wrote the article  “Evaluation fo the Conversion of the Brand Equivalent of Warfarin to its Generic.” I have concluded from my research as a PGY1 Pharmacy Practice Resident that it is safe to switch between generic warfarin and its brand equivalent. This switch was done in pharmacist-managed anticoagulation clinics with a onetime switch to generic warfarin. If it will save your patient money and is safe, why not?