Mechanism of action
Inhibits synthesis of vitamin K-dependent coagulation factors (II, VII, IX, X, protein C and S) via inhibition of activation of vitamin K.
Indications and dose
INR targets:
- DVT and PE: 2.0-3.0
- Atrial fibrillation: 2.0-3.0
- Bioprosthetic heart valves: 2.0-3.0
- Mechanical heart valves: 2.5-3.5
Side-effects
Bleeding
Skin reactions
Procoagulant effect with initiation of treatment (due to protein C and S depletion)
Precautions
Caution with drug to drug interactions.
Avoid in pregnancy.
Monitoring
Requires monitoring of prothrombin time via International Normalised Ratio (INR).
Pharmacokinetics
Routes: Oral
Onset: 24-72 hours
Duration: 2-5 days
Bioavailability: 79-100%
Metabolism: Hepatic
Half-life of elimination: 20-60 hours
Excretion: Urine
Medicinal forms
Tablet - 2 mg, 3 mg and 5 mg
References
