Heparin to Warfarin Bridging

[1818hst]

Hi, I recently came out of surgery and was given heparin injections (came off warfarin in advance of the surgery). I am now being bridged back to warfarin. I'm injecting 15,000 single doses of heparin while "reloading" my warfarin. The warfarin dosage is 12 mg. I have to do this for 3 days, and then cut the warfarin to 10 mg until I hit my target INR. On the fourth day I am supposed to inject 5,000 units of heparin and so on till I've reached my target INR. I trust my haematologist completely but am nervous that 15,000 of heparin plus 12 mg warfarin is a lot. Any thoughts?

[lupus-support1 Administrator]

Speak to your specialist about your worries. No one can ease your mind other than your own doctor.

Look after yourself and I hope you have a speedy and complete recovery from your surgery.

Be well!

With good wishes,

Ros

[MaryF Administrator]

It does sound like a good plan is in place for you, I have never had Warfarin, so can't personally comment, keep a close eye and report back to your consultant if anything is not right. MaryF

[GinaD]

I don’t recall the details, but this sounds similar to my successful bridging after hip surgery.

[Lure2]

What sort of surgery did you have? What therapeutic level of INR do you normally have?

Best wishes from Kerstin in Stockholm

[Saralmac]

That is similar to what I do for bridging, I'm usually on 10 mg therapeutic but take a long time getting there, I continue my regular heparin right up to when I hit 3-4 inr range.

[CheddarAddict]

Have been through something similar and this is how it was explained to me..

The way Warfarin works is it builds in your body, it's around 3 or 4 days from each dose to take effect on coagulation efficiently.. Heparin however is more of an instant and 24 hr duration effect, the drug working on a slightly different part of the coagulation process. Bridging is all about easing you off or back on Warfarin without a big hole in 'protection'

Similarly when you get an INR drop (it happens) if Warfarin dose does not adequately hold levels Heparin would be used to instantly boost/cover anticoagulation until sufficient INR is reached again.

Hope that makes sense

[Tim_Thorpe]

Had major stroke 2011 plus many mini strokes now have micro clots on my brain prof hunt said my antiphosolipid syndrome is so strong warfrin not working 😋 but have had two surgeries one major for a gangrus appendix and bi lateral phnewmonia ended up in intensive care unit for four days 😋lol and one miner surgery to repair hernia from previous operation 😜 had bridging plans

And never had any trouble with surgery at the time or after

All the best with your op sure you will be ok 👍