Pengaruh Asupan Vitamin K terhadap Stabilitas Rasio Normalisasi Internasional dan Efektivitas Terapi Warfarin
DOI:
https://doi.org/10.30595/pharmacy.v22i2.26889Keywords:
Antikoagulan ora, Stabilitas INR, Rentang Waktu Terapeutik, Vitamin K, WarfarinAbstract
Warfarin memiliki indeks terapi sempit dengan variabilitas respons tinggi. Fluktuasi asupan vitamin K dapat menyebabkan ketidakstabilan INR, namun hubungannya masih kontroversial. Tinjauan ini bertujuan untuk mengevaluasi pengaruh asupan vitamin K terhadap stabilitas INR dan efektivitas terapi warfarin. Tinjauan sistematis mengikuti PRISMA 2020 melalui PubMed (2010-2025). Dari 6.573 artikel, 9 studi di sertakan (4 RCT, 5 observasional) dengan penilaian kualitas menggunakan Cochrane RoB 2 dan Newcastle-Ottawa Scale. Hasil menunjukkan konsistensi asupan vitamin K lebih penting dibanding jumlah absolut dalam menjaga stabilitas INR. Suplementasi dosis rendah (150 mcg/hari) efektif menurunkan fluktuasi ekstrem INR. Pemberian vitamin K untuk INR tinggi (≥4) aman dan efektif menurunkan risiko perdarahan serta mortalitas tanpa meningkatkan tromboembolisme. Dapat disimpulkan bahwa konsistensi konsumsi vitamin K merupakan faktor kunci efektivitas terapi warfarin. Edukasi harus menekankan konsistensi daripada pembatasan ketat. Diperlukan RCT berskala besar dengan tindak lanjut lebih panjang dan integrasi data genetik.
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