{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T13:29:48Z","timestamp":1776086988332,"version":"3.50.1"},"reference-count":11,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2017,11,30]]},"abstract":"<jats:p>Long-acting anticoagulant rodenticides, also called superwarfarins, are known for their greater potency, longer half-life and delayed onset of symptoms. Cases of superwarfarin poisoning can pose a diagnostic and clinical challenge due to a wide array of presentations and prolonged severe coagulopathy requiring months of high-dose oral vitamin K therapy. The most common presentation of long-acting anticoagulant rodenticide poisoning is mucocutaneous bleeding, with other common presentations including haematuria, gingival bleeding, epistaxis and gastrointestinal bleeding. We discuss a case of deliberate self-poisoning with long-acting anticoagulant rodenticides presenting with haematuria and coagulation values above measurable limits. This case is important as it required immediate and maintenance therapy in order to prevent profound bleeding, as well as the evaluation of the patient\u2019s psychosocial factors to ensure medical compliance and to prevent refractory complications or repeated self-harm.<\/jats:p>","DOI":"10.1136\/bcr-2017-222170","type":"journal-article","created":{"date-parts":[[2017,12,20]],"date-time":"2017-12-20T23:19:24Z","timestamp":1513811964000},"page":"bcr-2017-222170","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Deliberate self-poisoning with long-acting anticoagulant rodenticides"],"prefix":"10.1136","volume":"2017","author":[{"given":"Danielle","family":"Reimer","sequence":"first","affiliation":[{"name":"College of Medicine, University of Central Florida, Orlando, Florida, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melissa","family":"Smith","sequence":"additional","affiliation":[{"name":"College of Medicine, University of Central Florida, Orlando, Florida, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sayed","family":"Ali","sequence":"additional","affiliation":[{"name":"Department of Medicine, Orlando Veterans Affairs Medical Center, Orlando, Florida, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2017,12,20]]},"reference":[{"key":"2025082707391874000_2017.dec19_1.bcr-2017-222170.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tmrv.2015.06.002"},{"key":"2025082707391874000_2017.dec19_1.bcr-2017-222170.2","doi-asserted-by":"publisher","DOI":"10.3109\/15563650.2011.587126"},{"key":"2025082707391874000_2017.dec19_1.bcr-2017-222170.3","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-6757(03)00088-3"},{"key":"2025082707391874000_2017.dec19_1.bcr-2017-222170.4","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/j.jad.2017.05.002","article-title":"The global burden of fatal self-poisoning with pesticides 2006\u201315: systematic review","volume":"219","author":"Mew","year":"2017","journal-title":"J Affect Disord"},{"key":"2025082707391874000_2017.dec19_1.bcr-2017-222170.5","doi-asserted-by":"crossref","first-page":"e1026","DOI":"10.1016\/S2214-109X(17)30299-1","article-title":"Prevention of suicide with regulations aimed at restricting access to highly hazardous pesticides: a systematic review of the international evidence","volume":"5","author":"Gunnell","year":"2017","journal-title":"Lancet Glob Health"},{"key":"2025082707391874000_2017.dec19_1.bcr-2017-222170.6","doi-asserted-by":"crossref","DOI":"10.1016\/j.mpmed.2011.12.002","article-title":"Warfarin and anticoagulant rodenticides","volume":"40","author":"Vale","year":"2012","journal-title":"Medicine"},{"key":"2025082707391874000_2017.dec19_1.bcr-2017-222170.7","doi-asserted-by":"publisher","DOI":"10.1002\/phar.1119"},{"key":"2025082707391874000_2017.dec19_1.bcr-2017-222170.8","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000005461","article-title":"Treatment of a long-acting anticoagulant rodenticide poisoning cohort with vitamin K1 during the maintenance period","volume":"95","author":"Long","year":"2016","journal-title":"Medicine"},{"key":"2025082707391874000_2017.dec19_1.bcr-2017-222170.9","doi-asserted-by":"publisher","DOI":"10.1067\/mem.2000.108317"},{"key":"2025082707391874000_2017.dec19_1.bcr-2017-222170.10","unstructured":"WHO. 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