Warfarin: Difference between revisions
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==Dosing== | ==Dosing== | ||
#Day 1: 5 to 7.5 mg po at night (to ensure absorption on an empty stomach), | |||
#Day 2, 3, 4...: 2.5 to 7.5 mg po qhs (most often 5 mg) | |||
Day 1: 5 to 7.5 mg po at night (to ensure absorption on an empty stomach), | |||
Day 2, 3, 4...: 2.5 to 7.5 mg po qhs (most often 5 mg) | |||
*An increase in INR of >0.3-0.4 units per day necessitates dose reduction | *An increase in INR of >0.3-0.4 units per day necessitates dose reduction | ||
*CHF, liver disease, Vitamin K def, drugs may influence warfarin response | *CHF, liver disease, Vitamin K def, drugs may influence warfarin response | ||
==Range (INR)== | ==Range (INR)== | ||
2.5 to 3.5: mechanical prosthetic valves or recurrent thromboembolism | 2.5 to 3.5: mechanical prosthetic valves or recurrent thromboembolism | ||
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==Reversal== | ==Reversal== | ||
#FFP (10-20/kg) to decr INR to 1.5 (should occur in 6-24 hr) | |||
#+/- Vitamin K (10 mg IM) (takes 24hrs to affect & 2wk to wear off) | |||
FFP (10-20/kg) to decr INR to 1.5 (should occur in 6-24 hr) | |||
+/- Vitamin K (10 mg IM) (takes 24hrs to affect & 2wk to wear off) | |||
==Potentiators== | ==Potentiators== | ||
==Source == | ==Source == | ||
1/26/06 DONALDSON (addapted from Lampe), EMP 1/11 | 1/26/06 DONALDSON (addapted from Lampe), EMP 1/11 | ||
[[Category:Drugs]] | |||
[[Category:Heme/Onc]] | [[Category:Heme/Onc]] | ||
Revision as of 13:44, 15 March 2011
Dosing
- Day 1: 5 to 7.5 mg po at night (to ensure absorption on an empty stomach),
- Day 2, 3, 4...: 2.5 to 7.5 mg po qhs (most often 5 mg)
- An increase in INR of >0.3-0.4 units per day necessitates dose reduction
- CHF, liver disease, Vitamin K def, drugs may influence warfarin response
Range (INR)
2.5 to 3.5: mechanical prosthetic valves or recurrent thromboembolism
2.0-3.0: all other indications
Reversal
- FFP (10-20/kg) to decr INR to 1.5 (should occur in 6-24 hr)
- +/- Vitamin K (10 mg IM) (takes 24hrs to affect & 2wk to wear off)
Potentiators
Source
1/26/06 DONALDSON (addapted from Lampe), EMP 1/11