- Warfarin is the most commonly used oral anticoagulant in the world.
Treatment for Atrial Fibrillation
- Patients with newly diagnosed atrial fibrillation can be started on warfarin directly.
- They do not need an initial course of LMW heparin unless they have had a recent stroke.
- Treatment should be started with a loading dose of 3mg or 5mg daily for the first 3 days of treatment.
- More information about warfarin.
Treatment for Deep Vein Thrombosis (DVT) or Pulmonary Embolus (PE)
- Treatment with warfarin requires a short course of LMW heparin initially.
- LMW heparin is given as soon as the diagnosis is suspected.
- In a confirmed case, LMW heparin is given for at least 5 days and continued until the INR is therapeutic.
- Warfarin is started at the time of diagnosis.
- A loading dose (typically 5mg daily) is given for 3 days and an INR check is performed on day 4.
- The dose is adjusted depending on the INR result.
- Warfarin is continued for 6 weeks to 6 months depending on the clinical condition.
- Warfarin tablets are taken once a day in the evening
- Regular blood tests are required to regulate the warfarin dose.
Patients with a DVT or PE associated with cancer usually remain on LMW heparin for the duration of the treatment period.
If Low Molecular Weight (LMW) Heparin is required:
Enoxaparin and Dalteparin are both available
- Treatment is given subcutaneously.
- Treatment is given once (1.5 mg/kg od) or twice a day (1 mg/kg bid).
- The dose is reduced if renal function is reduced (1mg/kg od).