Complete dosing information for warfarin sodium
Medical guidance required: Dosing information here is for educational purposes. Your healthcare provider will determine the appropriate dose based on your specific condition, kidney function, other medications, and medical history. Never adjust your dose without consulting your doctor or pharmacist.
Initial dosing: 2–5mg daily; initiate with 5mg unless elderly, malnourished, or hepatic impairment; Maintenance: 2–10mg daily based on INR. Average 4–5mg/day.; Elderly patients (>65 years): Start 2–2.5mg daily; titrate cautiously.; CYP2C9/VKORC1 genotype-guided: Start 1.5–10mg based on genetic factors if genotyping available
Off-label use in children: initial 0.1–0.2 mg/kg (max 10mg). Requires frequent INR monitoring.
No specific dose adjustment, but monitor carefully as uremic toxins can affect protein binding.
Use with extreme caution. Hepatic disease reduces clotting factor synthesis and warfarin metabolism. Very sensitive to dose.