Towards the safer use of warfarin I: an overview

There has been an exponential increase of warfarin usage in the community since several large and well-designed clinical trials have consistently found that warfarin can safely prevent embolic stroke in people with atrial fibrillation. Safe and effective warfarin treatment requires a case-by-case evaluation of each patient's clinical condition and risk factors for bleeding. It also demands a therapeutic partnership where patients can accept an educated responsibility for managing their own condition. This requires mutually understood plans for ongoing management, including dose adjustment and responses to under- or overdose and to bleeding complications.