Comparison of initial loading doses of 5 mg and 10 mg for warfarin therapy

Lastória, Sidnei; Fortes, Arcangelo T.; Maffei, Francisco Humberto de Abreu; Sobreira, Marcone Lima; Rollo, Hamilton Almeida; Moura, Regina; Yoshida, Winston Bonetti

doi:10.1590/jvb.2014.004

Cited by 3 publications

(3 citation statements)

References 14 publications

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“…Although it is not detected in our study, some researchers found that the use of 10 mg loading dose can result in achieving the target INR in shorter time compared to 5 mg [10]. Another study conducted by Sidnei et.,al Comparison of initial loading doses of 5 mg and 10 mg for warfarin therapy concluded that, Initial therapeutic warfarin doses of 5 mg or 10 mg are equally effective and safe for in-patient anticoagulant treatment of thromboembolic disease, irrespective of underlying disease [11]. There were several limitations to our study, the major one of this study was undertaken in a small patient's population.…”

Section: Discussionmentioning

confidence: 88%

Comparison between 5 mg and 10 mg warfarin loading doses therapy in cardiac care unit patients at Elobied Hospital, Elobied City- Sudan

M.E.Eltalib¹,

Ahmed²,

Elfaki³

et al. 2021

GSC Biol. and Pharm. Sci.

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Background and objectives: Warfarin sodium therapy is usually initiated with a loading dose to reduce the time needed to reach the target international normalized ratio (INR). The right initial dose of warfarin is controversial. This study aimed to determine the best initial dose of warfarin in terms of safety and efficacy. Patients and methods: This is a prospective hospital-based study. Fifty-nine patients who were admitted to the coronary care unit with clinical indication for warfarin were assigned to use the initial dose of warfarin 5 mg or 10 mg with the target INR of 2-3. An ethical clearance was obtained from the state ministry of health. A written consent was taken from each patient. An INR was measured at baseline and then after 72 hours. The data were then collected using a data sheet including age, gender, baseline INR, initial dose of warfarin, INR after 72 hours and whether the patient developed bleeding or not. Patients on Aspirin and other non-steroidal anti-inflammatory drugs were excluded. The data were analyzed using SPSS version 18. Results: A total number of 59 patients were enrolled in the study. In this series, 59% of patients were females. The mean age of patients was 56 years. Five mg loading dose was used in 35 of patients (59%) while 10 mg was used in 24 patients (41%). The mean INR after 72 hours was 2.8 for those with the initial dose of 5 mg. For those with the initial loading dose of 10 mg the mean INR after 72 hours was 3.2. Minor bleeding occurred in three patients, two of them used the initial loading dose of 5mg and only one patient from the group of 10mg. Conclusion: From this study, it seems that 5 mg loading dose of warfarin is reasonable and cost effective; nevertheless, 10mg initial loading dose is not associated with increased risk of bleeding.

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Section: Discussionmentioning

confidence: 88%

Comparison between 5 mg and 10 mg warfarin loading doses therapy in cardiac care unit patients at Elobied Hospital, Elobied City- Sudan

M.E.Eltalib¹,

Ahmed²,

Elfaki³

et al. 2021

GSC Biol. and Pharm. Sci.

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“…Lastoria S et al compared 5 mg versus 10 mg loading dose. The 10 mg dosage regimen took less time to attain the TR and was associated with lower warfarin doses at discharge and better INR at first out-patients follow-up visit [121]. A two-step dosing nomogram has been prospectively evaluated by Kim YK et al [99].…”

Section: Inr Testingmentioning

confidence: 99%

Follow-up and management of valvular heart disease patients with prosthetic valve: a clinical practice guideline for Indian scenario

Saksena

Mishra

Muralidharan

et al. 2019

Indian J Thorac Cardiovasc Surg

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Purpose Valvular heart disease (VHD) patients after prosthetic valve implantation are at risk of thromboembolic events. Followup care of patients with prosthetic valve has a paramount role in reducing the morbidity and mortality. Currently, in India, there is quintessential need to stream line the follow-up care of prosthetic valve patients. This mandates the development of a consensus guideline for the antithrombotic therapy in VHD patients post prosthetic valve implantation. Methods A national level panel was constituted comprising 13 leading cardio care experts in India who thoroughly reviewed the up to date literature, formulated the recommendations, and developed the consensus document. Later on, extensive discussions were held on this draft and the recommendations in 8 regional meetings involving 79 additional experts from the cardio care in India, to arrive at a consensus. The final consensus document is developed relying on the available evidence and/or majority consensus from all the meetings. Results The panel recommended vitamin K antagonist (VKA) therapy with individualized target international normalized ratio (INR) in VHD patients after prosthetic valve implantation. The panel opined that management of prosthetic valve complications should be personalized on the basis of type of complications. In addition, the panel recommends to distinguish individuals with various co-morbidities and attend them appropriately. Conclusions Anticoagulant therapy with VKA seems to be an effective option post prosthetic valve implantation in VHD patients. However, the role for non-VKA oral therapy in prosthetic valve patients and the safety and efficacy of novel oral anticoagulants in patients with bioprosthetic valve need to be studied extensively.

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“…En el estudio OPTIMEV (41) encontraron que la aparición de TVS en venas no varicosas aumentaba el riesgo de TVP concomitante (OR 1,8; IC 95% 1,1-2,7), mientras que la aparición de TVS en venas varicosas no presentaba una correlación significativa (p > 0,05). Sobreira et al (127) reportaron hallazgos similares mostrando que la probabilidad de aparición de TVP era hasta nueve veces mayor (OR 9.09; IC 95% 1.75-50.00) en TVS sobre venas no varicosas. En el ensayo clínico STEFLUX, uno de los factores de riesgo de recurrencia de TVS fue la ausencia de varices (44).…”

Section: A Características Generales De Los Pacientesunclassified

Factores de riesgo, complicaciones y evaluación del manejo de los pacientes con trombosis venosa superficial de miembros inferiores atendidos en servicios de urgencias españoles

Beddar Chaib

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Comparison of initial loading doses of 5 mg and 10 mg for warfarin therapy

Cited by 3 publications

References 14 publications

Comparison between 5 mg and 10 mg warfarin loading doses therapy in cardiac care unit patients at Elobied Hospital, Elobied City- Sudan

Comparison between 5 mg and 10 mg warfarin loading doses therapy in cardiac care unit patients at Elobied Hospital, Elobied City- Sudan

Follow-up and management of valvular heart disease patients with prosthetic valve: a clinical practice guideline for Indian scenario

Factores de riesgo, complicaciones y evaluación del manejo de los pacientes con trombosis venosa superficial de miembros inferiores atendidos en servicios de urgencias españoles

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