Annotations Adverse Effects

  • Bleeding
    • Most common adverse effect
  • Skin rash and alopecia
    • Uncommon
  • Skin necrosis
    • Rare
    • Due to insufficient time on warfarin prior to discontinuing heparin or LMW heparin
    • Must have 2 INRs > 2 prior to stopping heparin or LMW heparin
    • Investigate for deficiencies in Protein C and S
    • Heparin Induced Thrombocytopenia
  • Osteopenia
    • Rare


These guidelines do not establish a standard of care to be followed in every case. It is recognized that each case is different and those individuals involved in providing health care are expected to use their judgment in determining what is in the best interests of the patient based on the circumstances existing at the time. It is impossible to anticipate all possible situations that may exist and to prepare guidelines for each. Accordingly these guidelines should guide care with the understanding that departures from them may be required at times.

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