Warfarin therapy--a practical guide.

Abstract

Efficient anticoagulation with warfarin therapy requires optimal dosage. An international programme of standardization of prothrombin time tests has been developed in order to achieve correct dosage and efficient anticoagulation. Many South African laboratories use a more conservative therapeutic range for the prothrombin time than that recommended by international bodies. Consequently, warfarin dosage is often lower in the RSA than in many other countries. The use of a slightly lower therapeutic range in the RSA would improve anticoagulation without increasing the risk of haemorrhage. Practical guidelines for efficient warfarin therapy, including induction and maintenance dosage, therapeutic range, management of overdosage, contraindications and use during pregnancy and lactation, are discussed.