Over-anticoagulation is a frequent complication of warfarin therapy. Deliberate self-poisoning with warfarin occurs in patients with or without a requirement to maintain therapeutic anticoagulation. All patients are usually asymptomatic at presentation. The approach to therapy is determined by both the magnitude of over-anticoagulation and the indication (or not) for therapeutic anticoagulation. Patients with active bleeding require urgent combination reversal therapy. Vitamin K is the specific antidote.
References
- Baker RI, Coughlin PB, Gallus AS et al. The Warfarin Reversal Consensus Group Warfarin reversal: consensus guidelines, on behalf of the Australasian Society of Thrombosis and Haemostasis. Medical Journal of Australia 2004: 181(9):494-497.
- Isbister GK, Hackett LP, Whyte, IM. Intentional warfarin overdose. Therapeutic Drug Monitoring 2003; 25(6):715-722.
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