Guidelines for warfarin administration with Angiomax
- Angiomax and warfarin should be overlapped for a minimum of 5 days
- Do not start warfarin until the platelets reach at least 150,000
- Starting warfarin dose recommended to be 5 mg per day. No loading dose recommended.
- Combination of Angiomax and warfarin results in "false elevation" of INR. This does necessarily increase the risk of bleeding.
- Discontinue Angiomax when INR is greater than 3. An INR should be drawn 3 hr after the infusion is topped, to confirm that the INR is within desired therapeutic range. Notify prescriber.
- If the repeat INR is less than the desired therapeutic range, the most recent infusion rate should be restarted, INR drawn the next day and this process repeated until the INR is within the desired therapeutic range.
- Link to PDF of Angiomax Dosing Protocol