Vitamin K-dependent processes and potential interactions with anticoagulants

Abstract

Summarizes the biochemical basis of vitamin K‑dependent processes, including γ‑carboxylation of vitamin K‑dependent proteins and the role of the vitamin K cycle (VKORC1/GGCX) in maintaining the active cofactor pool. Vitamin K antagonists (warfarin) inhibit VKORC1, leading to functional depletion of reduced vitamin K and impaired maturation of coagulation factors, whereas DOACs act independently of this pathway. Major interaction routes (dietary variability, MK‑7 supplements, antibiotics and microbiota‑related effects) are systematized with emphasis on INR instability and clinical safety.