Effectiveness and safety of a 10mg warfarin initiation nomogram in Asian population

Anticoagulant responses to warfarin vary among patients,based on genetic factors,diet,concomitant medications,and disease state. we evaluated the effectiveness and safety of a 10mg warfarin initiation nomogram in an asian population. retrospective cross-sectional audit studies were conducted from march 2009 to march 2010. the use of a 10mg-loading dose to initiate warfarin treatment resulted in 33(84.6%) patients attaining a therapeutic inr within four days (mean time,2.6 days). there was no significant correlation between age,gender,race,and serum albumin for the time to reach a therapeutic inr. a significant correlation was noted for patient's baseline inr and time to reach a therapeutic inr (p<0.05). no significant differences were observed in time to reach a therapeutic inr in patients treated with specific class of concomitant drugs or patients with specific disease states. the overall incidence of over-anticoagulation was 35.9%; however,no bleeding episodes were encountered. in conclusion,the use of a 10mg warfarin nomogram was effective in rapidly achieving a therapeutic inr. however,the nomogram's safety is debatable owing to the high over-anticoagulation rate warfarin-administered patients. caution is recommended in the initiation of warfarin treatment using the 10mg nomogram. © 2015,pakistan journal of pharmaceutical sciences. all rights reserved.