Warfarin is an anticoagulant agent that is usually used as the sodium salt.
Warfarin acts as a vitamin K antagonist so affecting the synthesis of active factors II, VII, IX, X and protein C. The therapeutic goal is to cause a partial inhibition of clotting factor synthesis, to prolong prothrombin time 2 to 4 fold.
Warfarin may be used in the treatment of established thromboembolism, for example a deep venous thrombosis diagnosed by venogram, but heparin is used until the effect of warfarin is optimal.
The warfarin dose should be titrated against measured INR, although the exact therapeutic range for the INR has not been well established.
There is no good evidence of rebound hypercoagulability on stopping warfarin.
Warfarin has many drug interactions. Look in the BNF. Note, amiodarone particularly.
In cases of warfarin overdose:
There is evidence for the need for regular monitoring of full blood counts in atrial fibrillation patients on warfarin (1):
Reference:
Annotations allow you to add information to this page that would be handy to have on hand during a consultation. E.g. a website or number. This information will always show when you visit this page.