Br Med J (Clin Res Ed)  1984;288:1268-1270 (28 April), doi:10.1136/bmj.288.6426.1268

Flexible induction dose regimen for warfarin and prediction of maintenance dose.

A Fennerty, J Dolben, P Thomas, G Backhouse, D P Bentley, I A Campbell, P A Routledge

Fifty patients with venous thromboembolic disease being treated by heparin infusion received a three day warfarin induction regimen tailored according to the prothrombin time (British comparative ratio) measured on days 2 and 3. A prediction of the final maintenance dose of warfarin was made on the basis of a prothrombin time measured on day 4. All patients were safely anticoagulated by day 6, and the prediction was accurate to within 1 mg in 46 patients. Predicted and actual maintenance doses were closely related (r = 0.867; n = 50; p less than 0.001). This scheme should prove helpful in the control of anticoagulation, particularly in patients likely to be sensitive to warfarin, and should shorten hospital stay.


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