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Many physicians continue to use clinical judgment alone as the basis for initiating and adjusting warfarin dosages in patients who require oral anticoagulation. A number of studies have validated approaches to initiation of anticoagulation that provide more rapid anticoagulation with less chance of complications. The two widely used dosing options on the initiation of warfarin therapy are 5 mg and 10 mg per day. A small study 1 randomized 49 inpatients to receive initial doses of 5 mg or 10 mg, with subsequent adjustments made according to an algorithm that was not included in the article. All patients were simultaneously treated with heparin. Although patients in the mg group achieved a therapeutic level International Normalized Ratio greater than 2.
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Coumarin anticoagulant Used to prevent and treat thromboembolic disease Major hemorrhagic risks have decreased due to the adoption of INR method of monitoring and decreasing the intensity of anticoagulation for most indications; observe for drug interactions.
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