Document Detail

Safe introduction of warfarin for thrombotic prophylaxis in atrial fibrillation requiring only a weekly INR.
MedLine Citation:
PMID:  14738437     Owner:  NLM     Status:  MEDLINE    
A new protocol for initiating warfarin therapy was introduced to reduce the workload in the Anticoagulant Clinic. A total of 200 outpatients, with a median age of 74 years, requiring anticoagulation for atrial fibrillation, commenced warfarin 3 mg daily for 1 week. Patients were initially seen weekly, and subsequent warfarin doses were dictated by the International Normalized Ratio (INR) on days 8 and 15; 84% of patients followed the protocol correctly: of these 86% had an INR > or =2 by day 15 and >98% had INR >2 by day 22. By day 22, 58% of patients achieved a stable dose, 85% by day 29 and >95% by day 36. Day 8 INR was predictive of the final maintenance dose required. No patient suffered any thrombotic or haemorrhagic complications in the first month: only three patients had an INR >3 on day 8, and 11 patients had an INR >4 on day 15. Patient age and sex were not sufficiently related to warfarin requirement to provide useful predictive information. This protocol, requiring only weekly INRs, has proved safe and effective for outpatient warfarinization, and has reduced clinic attendances in this population.
S Janes; R Challis; F Fisher
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical and laboratory haematology     Volume:  26     ISSN:  0141-9854     ISO Abbreviation:  Clin Lab Haematol     Publication Date:  2004 Feb 
Date Detail:
Created Date:  2004-01-23     Completed Date:  2004-09-07     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7907061     Medline TA:  Clin Lab Haematol     Country:  England    
Other Details:
Languages:  eng     Pagination:  43-7     Citation Subset:  IM    
Department of Haematology, St Richard's Hospital, Chichester, UK.
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MeSH Terms
Age Factors
Aged, 80 and over / physiology
Anticoagulants / administration & dosage*,  adverse effects
Atrial Fibrillation / complications,  drug therapy*
Drug Administration Schedule
Follow-Up Studies
Hemorrhage / chemically induced
International Normalized Ratio / standards*
Middle Aged
Risk Factors
Sex Factors
Thrombosis / etiology,  prevention & control*
Time Factors
Warfarin / administration & dosage*
Reg. No./Substance:
0/Anticoagulants; 81-81-2/Warfarin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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