Warfarin started at 10 mg achieves therapeutic INR faster than 5 mg

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Warfarin started at 10 mg achieves therapeutic INR faster than 5 mg
PRACTICE RECOMMENDATIONS

Starting warfarin with 10 mg rather than 5 mg achieves a therapeutic international normalized ratio (INR) >1.9 one day earlier (4.2 vs 5.6 days) in selected outpatients at low risk for major bleeding complications with confirmed acute venous thromboembolism.

This strategy saves the time and expense of 1 daily INR determination, and it may decrease the number of days that low-molecular-weight heparin is required by 1 day— although all patients in this study, due to the nature of the design, received a minimum of 5 days of low-molecular-weight heparin.

No conclusions regarding differences in safety or efficacy between the 10-mg and 5-mg nomogram can be drawn from the results of this study, as it was underpowered to detect differences in these important endpoints.

 
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Kovacs MJ, Rodger M, Anderson DR, et al. Comparison of 10-mg and 5-mg warfarin initiation nomograms together with low-molecular weight heparin for outpatient treatment of acute venous thromboembolism. A randomized, double-blind, controlled trial. Ann Intern Med 2003; 138:714–719.

Alan Cementina, MD
Eric A. Jackson, PharmD
University of Connecticut School of Medicine and Saint Francis Hospital and Medical Center, Hartford, Conn. E-mail: [email protected].

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The Journal of Family Practice - 52(9)
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664-688
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Author and Disclosure Information

Kovacs MJ, Rodger M, Anderson DR, et al. Comparison of 10-mg and 5-mg warfarin initiation nomograms together with low-molecular weight heparin for outpatient treatment of acute venous thromboembolism. A randomized, double-blind, controlled trial. Ann Intern Med 2003; 138:714–719.

Alan Cementina, MD
Eric A. Jackson, PharmD
University of Connecticut School of Medicine and Saint Francis Hospital and Medical Center, Hartford, Conn. E-mail: [email protected].

Author and Disclosure Information

Kovacs MJ, Rodger M, Anderson DR, et al. Comparison of 10-mg and 5-mg warfarin initiation nomograms together with low-molecular weight heparin for outpatient treatment of acute venous thromboembolism. A randomized, double-blind, controlled trial. Ann Intern Med 2003; 138:714–719.

Alan Cementina, MD
Eric A. Jackson, PharmD
University of Connecticut School of Medicine and Saint Francis Hospital and Medical Center, Hartford, Conn. E-mail: [email protected].

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PRACTICE RECOMMENDATIONS

Starting warfarin with 10 mg rather than 5 mg achieves a therapeutic international normalized ratio (INR) >1.9 one day earlier (4.2 vs 5.6 days) in selected outpatients at low risk for major bleeding complications with confirmed acute venous thromboembolism.

This strategy saves the time and expense of 1 daily INR determination, and it may decrease the number of days that low-molecular-weight heparin is required by 1 day— although all patients in this study, due to the nature of the design, received a minimum of 5 days of low-molecular-weight heparin.

No conclusions regarding differences in safety or efficacy between the 10-mg and 5-mg nomogram can be drawn from the results of this study, as it was underpowered to detect differences in these important endpoints.

 
PRACTICE RECOMMENDATIONS

Starting warfarin with 10 mg rather than 5 mg achieves a therapeutic international normalized ratio (INR) >1.9 one day earlier (4.2 vs 5.6 days) in selected outpatients at low risk for major bleeding complications with confirmed acute venous thromboembolism.

This strategy saves the time and expense of 1 daily INR determination, and it may decrease the number of days that low-molecular-weight heparin is required by 1 day— although all patients in this study, due to the nature of the design, received a minimum of 5 days of low-molecular-weight heparin.

No conclusions regarding differences in safety or efficacy between the 10-mg and 5-mg nomogram can be drawn from the results of this study, as it was underpowered to detect differences in these important endpoints.

 
Issue
The Journal of Family Practice - 52(9)
Issue
The Journal of Family Practice - 52(9)
Page Number
664-688
Page Number
664-688
Publications
Publications
Topics
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Warfarin started at 10 mg achieves therapeutic INR faster than 5 mg
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Warfarin started at 10 mg achieves therapeutic INR faster than 5 mg
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