Part Two: Managing Warfarin Overdosing

Signs of Warfarin Overdosage

Any unusual bleeding

• Blood in stools or urine

• Excessive menstrual bleeding

• Bruising

• Excessive nose bleeds/bleeding gums

• Persistent oozing from superficial injuries

• Bleeding from tumor, ulcer, or other lesion

Notes:

Hemorrhagic complications from warfarin therapy are more likely to occur with excessive degrees of anticoagulation, but even with an INR in the therapeutic range, bleeding can occur. Because of the likelihood of finding an underlying lesion in an individual who has gastrointestinal bleeding or significant genito-urinary bleeding in the face of therapeutic levels of anticoagulation, one is advised to consider and evaluate for underlying abnormalities predisposing to the bleeding. The return on such evaluations in the face of an excessive degree of anticoagulation diminishes, and one must use judgement whether or not to pursue an evaluation.

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About this presentation:

The content of these pages is from a presentation called  "Management of Oral Anticoagulant Therapy: Principles & Practice," prepared by the American Heart Association's Post-Graduate Education Committee of the Council on Clinical Cardiology.  Supported by an educational grant from DuPont Pharmaceuticals.

Authors: Jack Ansell, M.D., Jack Hirsch, M.D., Nanette K. Wenger, M.D.

Data current as of October 1999.

Endorsed by the Anticoagulation Forum and the American Heart Association Council on Atherosclerosis, Thrombosis, and Vascular Biology.

The entire PowerPoint presentation is available from the American Heart Association.