Oral Anticoagulant therapy
Warfarin is the only oral anticoagulant readily available in New Zealand. There are two preparations available (Coumadin and Marevan). These have different pharmacokinetics therefore, as far as possible, patients should remain on the same product. If a product change has to be made the INR should be monitored more closely. If the patient is known to be allergic to Warfarin discuss management with a Haematologist.
Warnings
Pregnancy
Warfarin is contraindicated in pregnancy. All pregnant women requiring treatment for thromboembolism should receive subcutaneous LMWH treatment until delivery. After delivery warfarin can be used.
Breastfeeding
Warfarin is excreted in breast milk in very low amounts but is not considered to be a risk to the infant. It is recommended that management of pregnant patients be discussed with a haematologist and obstetrician.