Warfarin Counselling
Starting
Missed Dose
Take it ASAP. If only remembered next day, skip missed dose and continue as normal. Do not take 2 at one go.
Causes of INR changes
Signs of bleeding
Source
tasmania.healthpathways.org.au 2015
- Do not change brands (not interchangable)
- INR monitoring:
- Daily 1st 5 days (Takes 3-4 days to reach peak levels)
- Q2-3 days until 2 consecutive good readings
- Q1 week until 2 consecutive good readings
- Q2 weeks until 2 consecutive good readings
- Q monthly
Missed Dose
Take it ASAP. If only remembered next day, skip missed dose and continue as normal. Do not take 2 at one go.
Causes of INR changes
- Drug interaction (measure INR after starting new drug)
- Major diet change (avoid Vit K rich food - green veggies, avocado)
- Systemic illness (HF, liver failure, thyroid, diarrhoea, vomiting)
- Compliance
Signs of bleeding
- Non clotting cuts
- Gum bleeding
- Heavier than regular menses
- Haematuria
- Haemoptysis
- Haemetemesis
- Haematochezia/ malena
Source
tasmania.healthpathways.org.au 2015