INR 2 to 3: No change
Coumadin Clinic Protocols (adopted after Sacramento Heart Anticoagulation Clinic protocols) Purpose: To improve patient outcomes through education, patient assessment, monitoring of anticoagulation, dosage adjustment and follow-up care of those patients receiving anticoagulation therapy
Beneficial blood clots prevent or stop bleeding, but harmful blood clots can cause a stroke, heart attack, deep vein thrombosis, or pulmonary embolism
Warfarin Maintenance Dosing Protocol with INR Goal 1
9 INR 4
5 5 - 7
The dosage and administration of COUMADIN must be individualized for each patient according to Recommended
6 - 4
Patient Education Dosing Average Daily Dosing Most patients: start therapy at 5mg daily and adjust according to INR results Sensitive patients: start therapy at 1 – 2
Warfarin (brand names Coumadin and Jantoven) is a prescription medication used to prevent harmful blood clots from forming or growing larger
1 The
used if the dose is adjusted
In order to optimize the therapeutic effect and minimize complications such as bleeding, close monitoring of the degree of anticoagulation is required
Several anticoagulant options are available including vitamin K-antagonists The responses are derived from statements found in the 6th ACCP guidelines
The average daily maintenance dose is usually around 5 mg daily; however, there is wide variation, and the daily dose may be between 1–15 mg for some people
WARFARIN DOSING GUIDELINE PURPOSE: This document is intended as a guide to managing patients requiring warfarin therapy
5-2
Adjusted-dose warfarin versus low-intensity, fixed-dose warfarin plus aspirin Anticoagulation Management Clinical Topic Collection gathers the latest guidelines, news, JACC articles, education, meetings and clinical images pertaining to its cardiovascular topical area — all in one place for your convenience
In this case, our target dose will be equal to 100% − 20% = 80%, so
🎉 You may finish off by calculating the new dose for every single 7
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0–3
Recommended to use aspirin in addition, 50–100 mg daily, if low bleeding risk
0 INR < 1
1-9
The NICE guidelines state: “Consider a treatment dose of a low-molecular-weight heparin (LMWH) for young people and adults with COVID-19 who
Initially increases in warfarin dose may result in small changes in INR, however with higher doses, small adjustments may lead to much bigger changes in Below are some general guidelines on dosage adjustment in over-anticoagulated patients: Target INR range 2-3 INR Action 3
The UW Medicine Department of Pharmacy operates UW Medicine Anticoagulation Services and collaborates with multidisciplinary Recommendations on this Web site are based on data from over 1000 patients