Critical Care A Day
Q: In an averaged frame patients, the initial recommended warfarin/coumarin dose is?
B) 10 mg
The concept of "loading" dose of coumarin is no more acceptable unless a patient is known to require a higher dose of warfarin in the past. There are two rationales behind it. First, the "front-loading" of warfarin with 10 mg has shown to fail either rapid therapeutic anticoagulation or any therapeutic benefit, rather it can increase the risk of bleeding. Second, a higher loading dose (10 mg for the first few days) may cause a sudden fall in factors protein S and protein C, leading to a transient procoagulant state.
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