Genetic control of dicumarol levels in man

J Clin Invest. 1968 Dec;47(12):2657-63. doi: 10.1172/JCI105949.

Abstract

The mean half-life of dicumarol in the plasma of seven sets of identical and seven sets of fraternal twins after a single oral dose of 4 mg/kg was 43.6+/-SD 17.9 hr. Half-lives ranged from 7 to 74 hr in these 28 normal adults not receiving other drugs for 2 wk preceding dicumarol administration. Large differences among unrelated individuals in dicumarol half-life disappeared almost completely in identical twins, but persisted to some extent in most sets of fraternal twins. These results indicate that marked differences among subjects in dicumarol half-life are under genetic rather than environmental control. Reproducibility of values for dicumarol half-life was demonstrated. A direct relationship between the dose and the half-life of dicumarol occurred in unrelated volunteers administered progressively larger doses at 10-day intervals. Dose dependence of the half-life of a drug results in increased variability of half-life and hence in greater risks of toxicity on long-term therapy. Risks of toxicity on the one hand and of failure to anticoagulate adequately on the other can be reduced by determining dicumarol half-life before starting long-term therapy. Half-lives for dicumarol and phenylbutzone tended to be correlated in the 28 twins, but no correlation occurred between dicumarol and antipyrine half-lives.

MeSH terms

  • Adult
  • Antipyrine / blood
  • Caffeine
  • Centrifugation
  • Coffee
  • Dicumarol / blood*
  • Female
  • Genetics, Medical
  • Humans
  • Male
  • Methylcholanthrene
  • Middle Aged
  • Nicotine
  • Phenylbutazone / blood
  • Pregnancy
  • Prothrombin Time
  • Smoking
  • Spectrophotometry
  • Twins

Substances

  • Coffee
  • Caffeine
  • Methylcholanthrene
  • Nicotine
  • Dicumarol
  • Phenylbutazone
  • Antipyrine