Life On Warfarin

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What Is Warfarin?


Warfarin (also known as Coumadin) is an anticoagulant that works by inhibiting Vitamin K-dependent coagulation factors.

  • Theraputic doses of warfarin decrease the effects of Vitamin K-dependant clotting factor by approximately 30% to 50%.  
  • An anticoagulation effect generally occurs within 24 hours after the drug administration, though peak anticoagulant effect may be delayed 72 to 96 hours.  
  • The  action of a single dose of warfarin lasts 2 to 5 days, & the effects of warfarin may become more pronounced as effects of daily doses overlap.  
  • The dosage & administration of warfarin is individualized for each warfarin patient in accordance to the particular patient's PT/INR response to the drug.  

The elimination of warfarin is almost entirely by metabolism. Warfarin is eventually metabolized to reduced metabolities (warfarin alcohols), & excreted into the urine, & sometimes, the bile.

The objective of anticoagulation therapy is to decrease the clotting ability of blood so that blood clot is prevented, while avoiding spontaneous bleeding.

  • Numerous factors, alone or in combination including changes in diet, medications, botanicals etc may affect patient's response to warfarin. Therefore, regular PT/INR monitoring is advisable.  
  • An INR of greater than 4.0 appears to provide no additional theraputic benefit in most patients & is associated with higher risk of bleeding.  


Other Observations Include:

  • Elderly patients who are 60 years or older seem to exhibit greater than expected PT/INR response to the anticoagulant effects of warfarin. Hence, a lower dose of warfarin is usually required to produce similar therapeutic level of anticoagulation as patient age increases.
  • Asian patients may require lower initiation & maintenance doses of warfarin.


 *Above information is extracted from Bristol-Myers Squibb website. Special thanks to SDS, for sharing this information link.

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