RT Journal Article SR Electronic T1 Superwarfarin poisoning: challenges still remain JF BMJ Case Reports JO BMJ Case Reports FD BMJ Publishing Group Ltd SP e248385 DO 10.1136/bcr-2021-248385 VO 15 IS 5 A1 Ariadna de Genover Gil A1 Gabriel Manuel Gonzalez Suarez A1 Carla Moret Puig A1 Abelardo Hurtado Ganoza YR 2022 UL http://casereports.bmj.com/content/15/5/e248385.abstract AB Superwarfarin (long-acting anticoagulant rodenticide) poisoning should be suspected in unexplained bleeding with prolonged prothrombin time, especially in the absence of another explanation. Diagnosis and treatment of this intoxication remain a challenge as the direct analysis of superwarfarin in serum is not always possible. Therefore, toxin bioavailability remains unknown and close monitoring and treatment for long periods are required to avoid serious bleeding complications. Here, we discuss a case of suspected superwarfarin poisoning to highlight the challenges in early diagnosis and the challenges we encountered in treatment management and ensuring compliance for long periods.