• Treatment of DVT/PE:
    • Start 2-5 mg OD on day 1-2 of parenteral anticoagulant
    • Then individualized dose based on INR *3/12
    • Overlap with parenteral anticoagulant at least 5 days
    • Then discontinue parenteral anticoagulant once target INR x24h
    • Consider longer treatment if DVT/PE unprovoked
  • Prophylaxis of DVT/PE postpartum :
    • Start 2-5 mg OD
    • Then individualized dose based on INR *6/52
    • For women with prior VTE
  • Prophylaxis of thromboembolism/stroke:
    • Start with 2-5 mg OD
    • Individualize dose
    • Consider starting 10mg OD *2/7 in healthy outpatients

General dosing:

Adult: Initially 5-10 mg to be taken on day 1; subsequent doses dependent on the prothrombin time, reported as INR (international normalised ratio)

  • A lower induction dose can be given over 3/4 weeks in patients who do not require rapid anticoagulation
  • Elderly patients to be given a lower induction dose
  • Maintenance 3-9mg daily, to be taken at the same time each day
  • Tablet:
    • 1mg
    • 3mg
    • 5mg
  • INR target: 2-3
  • INR target for high-risk patients: 2.5-3.5
  • Can be taken with or without meals
  • Avoid sudden decreases and increases of Vitamin K (green leafy veggies, broccoli, liver, green tea, etc.)

Treatment conversion:

  • To convert from low molecular weight heparin/unfractionated heparin, overlap treatment at least 5 days, then discontinue LMWH/UFH once target INR reached x24h
  • To convert from rivaroxaban, discontinue other anticoagulant, start warfarin with parenteral anticoagulant at next scheduled anticoagulant dose

Oral anticoagulants

It inhibits vitamin K-dependent coagulation factor synthesis (Factors II, VII, IX, X, proteins C and S)

  • Acute kidney injury
  • Bleeding
  • Ecchymosis
  • Abdominal pain
  • Nausea & vomiting
  • Abdominal distension
  • Flatulence
  • Alopecia
  • Urticaria
  • Taste changes
  • Cold intolerance
  • Skin and tissue necrosis
  • Gangrene
  • Purple toes syndrome
  • Blood dyscrasias
  • Petechiae
  • Calciphylaxis
  • Cholestatic jaundice
  • Risk of bleeding
  • Hypersensitivity to class/compound
  • Active bleeding
  • Recent neurologic, ocular or traumatic surgery
  • Threatened abortion
  • Eclampsia or pre-eclampsia
  • Lab facilities inadequate
  • Unsupervised patient with high non-compliance risk
  • Spinal puncture
  • Regional or lumbar block anesthesia
  • Malignant hypertension
  • Severe hepatic/renal disease
  • Severe trauma
  • Diabetes
  • Mifepristone
  • Tamoxifen

                                   Drug Status

Availability Prescription only
Pregnancy Category D
Breastfeeding Contraindicated
Schedule Not controlled
BRAND NAME STRENGTH FORMULATION PACK SIZE MANUFACTURER DISTRIBUTOR
Warexx 5mg Tablet 100’s Metro Pharma Metro Pharma