What is the best starting dose of warfarin when initiating therapy?
What is the best starting dose of warfarin when initiating therapy? Evidence-Based Answer: When initiating warfarin, there is no difference between 5- and 10-mg starting doses or genotype-guided protocols in achieving a therapeutic international normalized ratio (INR) by day 5 of therapy. Age adjusted dosing regimens had fewer supratherapeutic INRs during initiation (SOR: A, meta-analysis). A 2-day loading dose of warfarin at 10 mg/d is an option, while 5 mg/d is preferred in the elderly or patients at increased risk of bleeding (SOR C, guideline based on case series).
Evidence Based Practice 18(7): E1