This advice is for those patients who are difficult to warfarinise.
Please:
- check medication and compliance and document that clearly in the referral
- ensure the patient is not taking vitamin K (e.g. Some food supplements contain vitamin K)
- check if the patient has had a recent large dose of vitamin K for warfarin reversal
- ensure dose being given is appropriate for BMI.
C.M & L.W 31-07-23
Who to refer:
Patients commenced on warfarin who show no increase in INR from baseline despite administration of doses of warfarin up to 15mg daily
Patients who have had therapeutic INRs that are subsequently difficult to dose – in such situations check compliance (and refer only if compliance appears satisfactory), ensure dose being given appropriate for BMI
Who not to refer:
Patients who are non-compliant with their medications
How to refer:
Please refer via SCI Gateway to the Department of Haematology, RIE.
Primary care investigations
- FBC
- U&Es and LFTS
