Many patients will require alternate day doses e.g. As such, doses should be given in whole tablet sizes. Warfarin is NOT evenly distributed within each tablet.antibiotics), or not tolerating oral, nasogastric or parenteral nutrition, the loading dose (see below) may need to be adjusted accordingly. If the patient is receiving other medications (eg.Patients with a primary cardiac indication for warfarin usually have their TTR determined by the referring cardiologist/cardiac surgeon. The following table provides common Target Therapeutic INR Ranges for specific clinical indications.Heparinoid therapy can be ceased when the INR is therapeutic for 2 consecutive days. Warfarin should be commenced whilst concurrent heparinoid (unfractionated heparin or low molecular weight heparin) therapy is being administered, in order to reduce the risk of thrombosis.For patient receiving infant formula or other enteral feeding formulations containing Vitamin K, at least 1 hour should separate the conclusion of a feed and the administration of warfarin. For babies exclusively breast fed, supplementing feeds with one formula feed/day to provide a constant intake of Vitamin K may be required.
Warfarin is the generic name for the most commonly used oral anticoagulant. The guideline may be modified according to individual patient requirements. All anticoagulant management within RCH occurs under the supervision and guidance of a Consultant Haematologist. This guideline is intended to inform medical and nursing staff employed within the Clinical Haematology department. Clinical Haematology: Warfarin Management Guideline
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