- 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 |