📋 Indications & Clinical Dosage
*Prophylaxis of embolisation in; rheumatic heart disease, atrial fibrillation, and after insertion of prosthetic heart valve, Prophylaxis and treatment ofvenous thrombosis and pulmonary embolism, Transient ischaemic attacks:*
Adult: Initially 5-10 mg, 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: a lower induction dose; maintenance 3-9 mg daily,
Children: Not recommended.
⛔ Contraindications
Haemorrhagic conditions, impaired renal or hepatic function, should not be used within 24 hours of surgery or labour.
⚠️ Precautions & Warnings
Hypertension. Weight changes, elderly, renal impairment, acute illness, vit K deficiency
🔄 Drug Interactions
NSAlDs, oral hypoglycemics, sulphonamides, quinidine, antibiotics, phenformin, cimetidine, drugs affecting liver enzymes, corticosteroids, imidazole antifungals, tarnoxifen.
⚠️ Adverse Reactions / Side Effects
Alopecia, rash, diarrhoea, fall in haematocrit.
Rare: warfarin use may lead to Calciphylax is, patients should consult their doctor if they develop a painful skin rash; if Calciphylaxis is diagnosed, stop treatment.
🤰 Pregnancy & Lactation Safety
Pregnancy Risk:
Contraindicated
Lactation / Breastfeeding:
Caution advised
📚 Official Regulatory & Clinical References
- Drug Regulatory Authority of Pakistan (DRAP): Drug Registration, S.R.O. Price Gazettes & National Essential Medicines List (NEML).
- World Health Organization (WHO): Collaborating Centre for Drug Statistics Methodology (ATC/DDD Index).
- Formulary Standards: British National Formulary (BNF) & Pakistan National Formulary (PNF) guidelines.