Starting Dose of Warfarin for Outpatient DVT Treatment

With the shift of treatment for deep venous thrombosis (DVT) and pulmonary embolism to the outpatient setting, initiating therapy with warfarin and low-molecular-weight heparin (LMWH) . . .

With the shift of treatment for deep venous thrombosis (DVT) and pulmonary embolism to the outpatient setting, initiating therapy with warfarin and low-molecular-weight heparin (LMWH) often falls to emergency physicians. In this double-blind, randomized study, the authors sought to find the most efficient warfarin starting dose. The primary endpoint was the number of days to reach a therapeutic international normalized ratio (INR). A secondary endpoint was the percentage of patients who achieved a therapeutic INR at 5 days.

A total of 201 consecutive outpatients with confirmed DVT were enrolled. Patients received subcutaneous LMWH for at least 5 days, until the INR was greater than 1.9. Warfarin treatment was administered according to nomogr…

Reviewing Author

J. Stephen Bohan, MS, MD, FACP, FACEP