• Risk Factors
• Therapeutic Ranges
• Loading Dose
• Duration of Treatment
• Warfarin Overdose
• Drug Interactions
• Surgery
• Alternative Loading Protocol

Risk factors for bleeding

• Age >65
• Albumin <30g/L
• Baseline INR >1.5
• Bilirubin >20µmol/L
• PCV <0.3
• Platelets <50x10 9 /L
• Creatinine >200umol/L
• Active malignancy
• Gastrointestinal bleed
• Recent stroke
• Uncontrolled CHF
• Alcoholism
• Major surgery < 14 days
• Severe hypertension
• Drug interactions