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Warfarin Dosing Protocols

The prescription drug warfarin (Coumadin) is used in the prevention of blood clots and generally prescribed to people with heart conditions. In certain cases, warfarin is used to prevent blood clots in the lungs and other veins. The effects of warfarin vary from individual to individual, requiring personalized monitoring and dosing adjustments. Because warfarin acts as an anticoagulant, meaning it slows the amount of time it takes for blood to clot, patients should exercise caution with cuts and other injuries.

  1. Starting Warfarin

    • Doctors generally prescribe warfarin at a starting dosage of 5 mg. The "Cleveland Clinic Journal of Medicine" advises that a dosage of 5 mg consistently has a more therapeutic effect on patients than 10 mg. When starting warfarin, your doctor will give you blood tests to measure your international normalized ratio (INR), to track the progress of your warfarin therapy. He may check your INR daily in the beginning stages of your therapy until your INR is stable. After an initial trial, the dosage of warfarin may be augmented to achieve a therapeutic INR. Certain patients may even receive varying dosages for specific days of the week, such as 3 mg Mondays and Fridays and 5 mg the rest of the week.

    Daily Dosage

    • Warfarin is a tablet taken once daily with or without food. Recommended dosage calls for the tablet to be taken at the same time every day. If you forget to take a dose at your normal time but remember it within that same day, take it as soon as you remember. However, do not double up on the dosage the next day if you forgot the previous day. Call your physician in case of a missed dose. Your doctor will begin with a low dose and augment it according to your blood tests. Be sure to understand your new dosing instructions, as some patients receive different doses for different days.

    Precautions

    • After starting your warfarin therapy, be very careful not to take more than one medication containing warfarin at the same time. Let your doctor know if you are taking any other medications containing warfarin or Coumadin as this will effect your dosage. Maintain a healthy diet and that includes foods high in vitamin K; however, be sure to keep your vitamin K levels consistent. Foods high in vitamin K include: spinach, broccoli, soy beans, tofu and cabbage. Your doctor will go over all dietary restrictions and other precautions that are specific to you.

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