Treatment must be individualized and based on estimates of patient benefit versus risk. If INR value outside therapeutic range and no signs or symtoms of thromboembolic complications or bleeding, have PT done again in 3 days. Monitor regularly, about once every 4-6 weeks, when anticoagulation level is stable. Skin rash and alopecia are uncommon adverse effects and may be managed by changing oral anticoagulants. Skin necrosis is a rare complication and usually appears within a few days of the start of oral anticoagulation therapy.
Drug interactions are the commonest cause of significant change in the INR value.
Patients should be advised not to change any medication without a physician's or pharmacist's advice. Adequate monitoring is the key to a successful and safe warfarin therapy. Please refer to the T.I.G. brochure on warfarin therapy. Laupacis et al. 352S -363S. Laupacis et al.