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Warfarin is an oral anticoagulant which acts as an antagonist of vitamin K.
Warfarin is indicated in acute venous thromboembolism targeting an international normalised ratio (INR) of 2.5. This state is typically only achieved after approximately five days' treatment, and so a parenteral anticoagulant is co-prescribed during this period.
Patients being considered for cardioversion should be anticoagulated with warfarin for three weeks prior to the procedure and for four weeks following it.
Patients with antiphospholipid syndrome, or who have atrial fibrillation and are assessed at high risk of stroke, or who have mitral stenosis of regurgitation with other cardiac risk factors should receive warfarin targeting an INR of 2.5.
Patients with prosthetic heart valves should be anticoagulated targeting an INR specific to their prosthesis type. Patients with previous MI or dilated cardiomyopathy who are are deemed suitable should be anticoagulated targeting INR 2.5.
