Coumadin orders
Coumadin warfarin , heparin or other prescription blood thinners such as lovenox , fragmin , innohep , arixtra , pradaxa , etc.
Information about Coumadin.
This list is not complete and many other drugs can interact with warfarinThis includes prescription and over-the-counter medicinesvitaminsand herbal productsGive a list of all your medicines to any healthcare provider who treats you.
Prothrombin complex concentratePCCfresh frozen plasmaor activated Factor VII treatment may be considered if the requirement to reverse the effects of COUMADIN is urgentA risk of hepatitis and other viral diseases is associated with the use of blood productsPCC and activated Factor VII are also associated with an increased risk of thrombosisThereforethese preparations should be used only in exceptional or life-threatening bleeding episodes secondary to COUMADIN overdosage.
COUMADIN can cause major or fatal bleedingBleeding is more likely to occur within the first monthRisk factors for bleeding include high intensity of anticoagulationINR4.0age greater than or equal to 65history of highly variable INRshistory of gastrointestinal bleedinghypertensioncerebrovascular diseaseanemiamalignancytraumarenal impairmentcertain genetic factorssee CLINICAL PHARMACOLOGYcertain concomitant drugssee DRUG INTERACTIONSand long duration of warfarin therapy.
In patients with non-valvular AF that is persistent or paroxysmal and at high risk of strokei.ehaving any of the following featuresprior ischemic stroketransient ischemic attackor systemic embolismor 2 of the following risk factorsage greater than 75 yearsmoderately or severely impaired left ventricularsystolic function and/or heart failurehistory of hypertensionor diabetes mellituslong-term anticoagulation with warfarin is recommendedIn patients with non-valvular AF that is persistent or paroxysmal and at an intermediate risk of ischemic strokei.ehaving 1 of the following risk factorsage greater than 75 yearsmoderately or severely impaired left ventricular systolic function and/or heart failurehistory of hypertensionor diabetes mellituslong-term anticoagulation with warfarin is recommendedFor patients with AF and mitral stenosislong-term anticoagulation with warfarin is recommendedFor patients with AF and prostheticheart valveslong-term anticoagulation with warfarin is recommendedthe target INR may be increased and aspirin added depending on valve type and positionand on patient factors.
An INR of greater than 4.0 appears to provide no additional therapeutic benefit in most patients and is associated with a higher risk of bleeding.
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