DRUG SUPPLIED DOSE COMMENTS
WARFARIN (Paeds)
(Coumadin)

Mechanism of action:

Anticoagulant; inhibits synthesis of vitamin-K dependent clotting factors



Ref: 32, 90


Last update: 2019-09-01		 tablet: 1 mg, 2 mg, 2.5 mg, 5mg
 Children:
Initial Dose: 0.2 mg/kg/dose PO.
Subsequent doses should be adjusted to maintain INR in desired range.

Reduce this to 0.1 mg/kg in patients with Fontan circulation, liver dysfunction or renal impairment.

Titrate daily maintenance dose to goal INR range as per protocol.		 Haematology consult suggested for non cardiac patients

Many drugs interact with warfarin,( CYP2C9).

Closer monitoring may be required when interacting medication is initiated or discontinued.

for details on adjusting warfarin dose based on INR, interactions and for the use of Vitamin K as an antidote for bleeding, see information sheet and protocol

Full teaching should be performed on all patients initiated on warfarin.

Increased risk of bleeding if patient on other antiplatelet agents eg ASA or other NSAIDs such as ketorolac, naproxen, ibuprofen.

See warfarin information sheet and Protocol for Warfarin Therapy in References and Supplementary.


Standard Prescription:

warfarin__mg PO once daily (__mg/kg/24hr)