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The risks of warfarin use in the elderly

The use of warfarin in the elderly, particularly for stroke prevention in chronic atrial fibrillation, is steadily increasing. Although the benefits of warfarin are greatest in the elderly, so are the risk of adverse outcomes and the difficulties of anticoagulant management. Clinical systems need to improve to counter this therapeutic dilemma, as warfarin is likely to remain the only widely available oral anticoagulant for the foreseeable future. Aspects that require attention are: the careful selection of patients in whom treatment with warfarin is appropriate; initiating therapy in a low dose (e.g., 2.5 – 5 mg/day); thorough education of patients and carers; close monitoring, especially with any change in the patient's regular drug therapy; involving patients more in the management of their warfarin therapy (self-monitoring/management in suitable patients); and ongoing review of the appropriateness of therapy as circumstances change.

History

Publication title

Expert Opinion on Drug Safety

Volume

5

Pagination

417-431

ISSN

1474-0338

Department/School

School of Pharmacy and Pharmacology

Publisher

Ashley Publications Ltd

Place of publication

London, UK

Rights statement

Copyright © 2006 Informa Plc

Repository Status

  • Restricted

Socio-economic Objectives

Other health not elsewhere classified

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