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Warfarin dosing and body mass index.

Julia A Mueller1, Tulsi Patel, Ahmad Halawa

  • 1Mayo Clinic, Jacksonville, FL, USA.

The Annals of Pharmacotherapy
|February 22, 2014
PubMed
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Body Mass Index (BMI) is positively correlated with total weekly warfarin dose. Higher BMI in patients requires increased warfarin dosage for therapeutic effect, impacting anticoagulant management.

Keywords:
anticoagulationbody mass index (BMI)warfarin

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Area of Science:

  • Pharmacology
  • Clinical Medicine
  • Biostatistics

Background:

  • Warfarin is a widely prescribed anticoagulant for venous thromboembolism.
  • Factors influencing warfarin dosing include diet, medications, and patient characteristics.
  • Optimal warfarin dosing is crucial to minimize risks of under- or over-dosing.

Purpose of the Study:

  • To investigate the association between Body Mass Index (BMI) and the total weekly dose (TWD) of warfarin.
  • To determine if BMI is a significant factor in warfarin maintenance dosing.

Main Methods:

  • Retrospective study of 831 patients on warfarin.
  • Analysis of international normalized ratio (INR) to ensure therapeutic range.
  • Correlation analysis between TWD and BMI in obese and nonobese patients.

Main Results:

  • A significant positive correlation was found between BMI and TWD.
  • Each 1-point increase in BMI correlated with a 0.69 mg increase in weekly warfarin dose.
  • A formula was derived to estimate weekly warfarin dose: 12.34 + 0.69 × BMI.

Conclusions:

  • BMI is a significant factor associated with TWD of warfarin.
  • Higher BMI necessitates higher warfarin doses for maintaining a therapeutic INR.
  • Findings have implications for warfarin dosing strategies in clinical practice.