16th May 2025

A 68-year-old gentleman who has been on long-term warfarin therapy for recurrent PE is seen in the anticoagulation clinic because his warfarin requirement has decreased significantly.

A 68-year-old gentleman who has been on long-term warfarin therapy for recurrent PE is seen in the anticoagulation clinic because his warfarin requirement has decreased significantly. He has recently started a prolonged course of metronidazole for a dental abscess. Inhibition of which cytochrome p450 enzyme is responsible for this change in warfarin requirement? 

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