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What do I need to know about Vitamin K, if I am taking warfarin (Coumadin)? Changes in the amount of vitamin K in the diet can alter the metabolism of warfarin (Coumadin Â®). However, vitamin K does not influence the action of other blood thinners, such as heparin or low molecular weight heparins (Lovenox Â®. Fragmin Â®, or Innohep Â®).
Scheme shows the cyclic metabolism of vitamin K in relation to the conversion of glutamate (Glu) to gg-carboxyglutamate (Gla) residues for the coagulation protein prothrombin. A general term for the glutamate precursors of vitamin K-dependent proteins is proteins induced by vitamin K absence, abbreviated PIVKA. For prothrombin (factor II) the glutamate precursor is known as PIVKA-II. The active form of vitamin K needed for carboxylation is the reduced form, vitamin K quinol. Known enzyme reactions are numbered 1, 2, and 3. The carboxylation reaction is driven by a vitamin K-dependent carboxylase activity (reaction 1) which simultaneously converts vitamin K quinol to vitamin K 2,3-epoxide.