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What Is The Safest Way To Start Warfarin?
Question: I have read the report issued in November 2013 about the increased risk of stroke in the first month of starting warfarin. What is your opinion on this and what would you consider the safest way of starting. I am having to consider taking coagulation for PAF but also have moderate kidney damage due to Diabetes and know that my platelet count can vary.
Brief Answer:
Following the safest way to start warfarin...
Detailed Answer:
Hi and thank you for asking to HCM!
Warfarine is the golden standard for preventing stroke. The therapeutical dose is titrated in order to mantain an INR levels between 2-3. Usually it needs 2-3 days from the beginning of therapy in order to achive this goal.
The best way to start warfarin is to begin it together with a low molecular weight heparine such as Clexane or Fragmine. This will help during the two first day of therapy.
Also to avoid side effects of Warfarine than I would suggest to do INR analysis every 3 days for the first two weeks for a better monitoring.
Hope this was of help!
Dr. Benard
Following the safest way to start warfarin...
Detailed Answer:
Hi and thank you for asking to HCM!
Warfarine is the golden standard for preventing stroke. The therapeutical dose is titrated in order to mantain an INR levels between 2-3. Usually it needs 2-3 days from the beginning of therapy in order to achive this goal.
The best way to start warfarin is to begin it together with a low molecular weight heparine such as Clexane or Fragmine. This will help during the two first day of therapy.
Also to avoid side effects of Warfarine than I would suggest to do INR analysis every 3 days for the first two weeks for a better monitoring.
Hope this was of help!
Dr. Benard
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Thank-you. Does the question of moderate kidney damage and changeable platelet count cause any problems with Warfarin use?
Brief Answer:
Platelet count should be monitored every month...
Detailed Answer:
Hi and welcome back!
Moderate kidney damage theoretically may interfere with warfarin dose but practically the dose is adjust based on the INR levels (no clinical importance).
The changeable platelet counts should be taken into account and I recommend that platelet count should be monitored every month together with INR levels.
Hope this was of help!
Wish you health!
Dr. Benard
Platelet count should be monitored every month...
Detailed Answer:
Hi and welcome back!
Moderate kidney damage theoretically may interfere with warfarin dose but practically the dose is adjust based on the INR levels (no clinical importance).
The changeable platelet counts should be taken into account and I recommend that platelet count should be monitored every month together with INR levels.
Hope this was of help!
Wish you health!
Dr. Benard
Above answer was peer-reviewed by :
Dr. Prasad
Can you explain why someone with only very occasional PAF of short duration (a few hours at most) mostly less than an hour still forms blood clots and needs to take warfarin. I thought the heart needed to fibrillate for over 24 hours before clotting occurred.
Brief Answer:
Explanations to your query...
Detailed Answer:
Hi back!
What you are saying is true for the first PAF. It needs more than 48 h for the clotting to occur. However if your PAF are frequent the risk of clotting increased and it may take less than 1-2 hours for clotting to occur (the time is shorten because of preexisting conditions). This is why anticoagulation is the best thing to do in this case for preventing embolism and stroke.
Hope this was of help!
Wish you health!
Dr. Benard
Explanations to your query...
Detailed Answer:
Hi back!
What you are saying is true for the first PAF. It needs more than 48 h for the clotting to occur. However if your PAF are frequent the risk of clotting increased and it may take less than 1-2 hours for clotting to occur (the time is shorten because of preexisting conditions). This is why anticoagulation is the best thing to do in this case for preventing embolism and stroke.
Hope this was of help!
Wish you health!
Dr. Benard
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
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