Warfarin low-dose

Herlitz J, Holm J, Peterson M, Karlson BW, Haglid Evan-der M, Erhardt L. Effect of fixed low-dose warfarin added to aspirin in the long term after acute myocardial infarction the LoWASA Study. Enr Heart J 2004 25 232-9. 

Poller, L. and F.R.C. Path The Effect of Low Dose Warfarin on the Risk of Stroke in Patients with Nonrheumatic Atrial Fibrillation, New Eng J. Med.. 129 (July 1L 1992),... 

Of 256 patients with myeloma randomized to thahdomide or not, 221 received no prophylactic anticoagulation and 35 received low-dose warfarin 1 mg/day (31). The incidence of deep venous thrombosis was higher in those who took thahdomide (hazard ratio 4.5). Warfarin did not reduce the risk, and prophylactic subcutaneous enoxa-parin 40 mg/day was therefore introduced in 68 patients of a subsequent group of 130 patients who received thalidomide. This intervention eliminated the difference in the incidence of deep venous thrombosis between those who took thalidomide and those who did not. 

Gedge J, Orme S, Hampton KK, et al. A comparison of a low-dose warfarin induction regimen w ith the modified Fennerty regimen in elderly inpatients. Age Ageing 2000 29(l ) 3I 4. 

Coumadin Aspirin Reinfarction Smdy (CARS) Investigators. Randomised, double-blind trial of fixed low-dose warfarin with aspirin after myocardial infarction. Lancet 1997 350 389-396. 

Patients with pre-existing heart disease, cerebrovascular disease, and hypertension should be closely monitored during treatment most cardiovascular complications occur within the first 2 months to 1 year of treatment low-dose warfarin (1-2 mg/day) is commonly used to decrease risk of thromboembolic events, but its value is not proven Doses should be taken on an empty stomach (1 hour before or 2 hours after a meal) avoid concurrent administration with dairy products or calcium compounds refrigerate... 

Lj-Saw-Hee FL, Blann AD, Lip GY Effects of fixed low-dose warfarin, aspirin-warfarin combination... 

In a large study in patients with atrial fibrillation, the eumulative ineidence of bleeding events after 3 years was no different in those teeeiving fixed low-dose warfarin 1.25 mg daily plus aspirin 300 mg daily (24.4%) than with fixed low-dose warfarin alone (24.7%) or aspirin 300 mg daily alone (30%). This sfudy also confained an adjusted-dose warfarin-only group, which proved more effective than the other group, so the study was terminated early. Other studies have found similar results. ... 

Prospective (1984) 4 healthy subjects Low.dose warfarin Infhivac Intramuscular No change in average prothrombin time at 7, II, 14, 16, 21 and 28 da after ccination, and no change in warftrin leveb 4... 

Singer, D. E., The effects of low-dose warfarin on the risk of stroke in patients with nonrheumatic atrial fibrillation. New Engl. J. Med., 323, 1505-1511 (1990). 

In patients who have had a catheter-related venous thrombosis, warfarin therapy (INR 2) is recommended for the duration of the catheter. Low-dose warfarin (1 mg/day) is now often used prophylacti-cally in the cancer population (Bern et al. (1990). 

Patients receiving continuous epidural anesthesia and low-dose warfarin therapy should have their PT/... 

Medication that improves patency includes antiplatelet agents, fish oil and calcium channel blockers [27]. A Cochrane review investigated the effect of adjuvant medical treatment to improve patency rates of AVF and AVG. The results of the meta-analysis showed a positive effect of antiplatelet treatment on VA patency in the short term. An included trial comparing low-dose warfarin with placebo was stopped early due to increased bleeding complications in the treatment group [28]. 

Administered to achieve an INR of 2.5 (range 2-3) in combination with low-dose aspirin pharmacotherapy (<100 mg daily [Chest guidelines] or 75-162 mg daily [Circulation guidelines]) for 3 mo postmyocardial infarction. Repeat echocardiogram before discontinuing warfarin pharmacotherapy... 

Warfarin (Aithal, 1999 Taube, 2000) CYP2C9 697 Low dose needed to prevent bleeding (7) 34 5.9 16 97... 

Primary prevention of venous thrombosis reduces the incidence of and mortality rate from pulmonary emboli. Heparin and warfarin may be used to prevent venous thrombosis. Subcutaneous administration of low-dose unfractionated heparin, low-molecular-weight heparin, or fondaparinux provides effective prophylaxis. Warfarin is also effective but requires laboratory monitoring of the prothrombin time. 

In present times, because of early mobilization and shorter stays in hospital, venous thrombosis in the legs and resulting pulmonary embolism has declined to a large degree. In persons with acute myocardial infarction, prophylactic low-dose heparin has reduced the incidence of venous thrombosis in the legs. It is considered as a reasonable alternative to warfarin in selected patients. Preventive anlicoagulalion may be indicated in some cases to prevent strokes due to left ventricular mitral thrombi embolizing in tire brain. 

When given in combination with warfarin or thienopyri-dine class of antiplatelet agents the ASA dose is usually lowered to 80 to 100 mg based on a post hoc analysis of data from the clopidogrel in unstable angina to prevent recurrent events (CURE), which showed similar efficacy but less major bleeding with the low dose (< 100 mg) of ASA (38). 

Pridiard PJ, Kitchingman GK, Walt RP Daneshmend TK, Hawkey CJ Human gastric mucosal bleeding induced by low dose aspirin, but not warfarin. Brit. Med. J. 298 493, 1989... 

Meade TW, Brennan PJ, Wilkes HC, Znhrie SR. Thrombosis prevention trial randomised trial of low-intensity oral anticoagulation with warfarin and low-dose aspirin in the primary prevention of ischaemic heart disease in men at increased risk. The Medical Research Council s General Practice Research Framework. Lancet 1998 351(9098) 233-41. 

Dicoumarol, warfarin + paracetamol With especially large doses, increase in anticoagulant effect Possibly displacement from protein. Depression of clotting factor synthesis Use low doses of paracetamol. Probably the safest mild analgesic to use with oral anticoagulants... 

Data from two large, randomized trials demonstrate that the use of low, fixed-dose warfarin (mean INR 1.4) combined with aspirin or of low-intensity anticoagulation (mean INR 1.8) monotherapy provides no significant clinical benefit compared with aspirin monotherapy but significantly increases the risk of major bleeding. Therefore, warfarin therapy targeted to an INR of less than 2 cannot be recommended for secondary prevention of CHD events following MI. 

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