Chest
SupplementAntithrombotic and Thrombolytic Therapy, 8th ED: ACCP GuidelinesPharmacology and Management of the Vitamin K Antagonists: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition)
Section snippets
Initiation and Maintenance Dosing
2.1.1. In patients beginning vitamin K antagonist (VKA) therapy, we recommend the initiation of oral anticoagulation with doses between 5 mg and 10 mg for the first 1 or 2 days for most individuals, with subsequent dosing based on the international normalized ratio (INR) response (Grade 1B). At the present time, for patients beginning VKA therapy without evidence from randomized trials, we suggest against the use of pharmacogenetic-based initial dosing to individualize warfarin dosing (Grade
CONFLICT OF INTEREST DISCLOSURES
Dr. Anselldiscloses that he has received consultant fees from Bristol-Myers Squibb, Roche Diagnostics, and International Technidyne Corporation. He is also on the speakers bureau for Roche Diagnostic Corporation and Sanofi-Aventis, and is the past president of the Anticoagulation Forum.
Dr. Hirshdiscloses that he has received partial support for writing two books, one on fondaparinux and one on low-molecular-weight heparin.
Dr. Jacobsondiscloses that he has received grant monies from the National
ACKNOWLEDGMENT
We wish to acknowledge the important assistance of Ann Wittkowsky, Pharm D, in developing these guidelines.
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