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Warfarin is an oral anticoagulant drug, and remains the most widely used in its category. Its primary use is to prevent and treat venous thrombosis, and to prevent and stop the extension of clots. This is also the rationale for its use in atrial fibrillation.
The most common indications for warfarin are:
More doubtful indications include:
In most situations, the dose of warfarin is adjusted in the individual patient to maintain an INR of 2 to 3. Warfarin dosage and maintenance is a problem because of its narrow threshold of safety and long half-life in circulation. This leads to a dose-response relationship which makes toxicity as well as ineffective treatment a frequent possibility. The aim of therapy is to make sure the patient receives the dose of warfarin that is the lowest possible to keep clots from forming or extending.