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Pharmacy Progress Note: Follow-Up Dosing per Collaborative Practice

Pharmacy Progress Note: Follow-Up Dosing per Collaborative Practice 2025

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The document outlines the procedures and protocols for follow-up warfarin dosing at UConn Health's John Dempsey Hospital, detailing patient identification, clinical data requirements, and the collaborative practice agreement that allows pharmacists to manage warfarin therapy under specific guidelines.

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What are the rules for taking warfarin?

The daily maintenance dose of warfarin is usually 39 mg, taken at the same time each day. The exact maintenance dose is dependent on the INR or other appropriate coagulation tests. Once the maintenance dose is stabilized in the therapeutic range, it is rarely necessary to alter it.

What is the standard process for taking warfarin?

Warfarin is taken once a day, usually in the evening. Its important to take your dose at the same time each day, before, during or after a meal. The aim of warfarin therapy is to decrease the bloods tendency to clot, but not stop it clotting completely.

How do you initiate warfarin?

The two widely used dosing options on the initiation of warfarin therapy are 5 mg and 10 mg per day. A small study1 randomized 49 inpatients to receive initial doses of 5 mg or 10 mg, with subsequent adjustments made ing to an algorithm that was not included in the article.

What are the tips for taking warfarin?

Take it at around the same time each day. This is so that if you need to change the dose after a routine blood test, you can do this the same day rather than waiting until the following morning. Warfarin does not usually upset your stomach, so you can take it with or without food.

How do I start warfarin?

Initiate warfarin as soon as possible following diagnosis of VTE, preferably on the same day, in combination with UFH, LMWH or fondaparinux. The initial dose of warfarin should be 5 or 10 mg for most patients.

What are the guidelines for warfarin doses?

Warfarin should usually be started at a dose of 5 mg per day. A 10-mg dose more frequently results in a supratherapeutic international normalized ratio (INR). Amiodarone, fluconazole, metronidazole, trimethoprim- sulfamethoxazole, and many other drugs inhibit the metabolism of warfarin.

Pharmacy Progress Note: Follow-Up Dosing per Collaborative Practice 2025

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