Clotblog with Dr Samuel Goldhaber

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Nonhemorrhagic adverse effects of warfarin

Jun 22, 2012 07:35 EDT


The nonhemorrhagic side effects of warfarin—including alopecia, osteoporosis, coronary artery calcification, a feeling of being cold, and fatigue—are certainly less serious than hemorrhagic side effects (such as major GI bleeding) but it's nonetheless important to monitor them.

Have your patients experienced other nonhemorrhagic side effects of warfarin?

See:

Weijs B, Blaauw Y, Rennenberg RJMW, et al. Patients using vitamin K antagonists show increased levels of coronary calcification: An observational study in low-risk atrial fibrillation patients.  Eur Heart J 2011; 32:2555-2562. Abstract.

Caraballo PJ, Heit JA, Atkinson EJ, et al. Long-term use of oral anticoagulants and the risk of fracture.  Arch Intern Med 1999; 159:1750-1756. Abstract.

Budnitz DS, Lovegrove MC, Shehab N, et al. Emergency hospitalizations for adverse drug events in older Americans. N Engl J Med 2011; 365:2002-2012. Abstract.








Your comments
Nonhemorrhagic adverse effects of warfarin
# 1 of 1
September 1, 2012 10:42 (EDT)
Champ Barber

Dr. Goldhaber:

 What has been your experience with hypotension that appears to be directly related to warfarin use and not related to the disease state or another underlying cause in your patients?  I have been unable to find any primary literature that shows a direct causal relationship but have had several patients report lower blood pressure that seems to be unrelated to their disease states.  Thank you for your time.

Champ Barber, PharmD, BCPS


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Who's Talking
Samuel Z Goldhaber, MD
Professor of Medicine
Harvard Medical School
Director, Venous Thromboembolism Research Group
Co-Director, Anticoagulation Management Service
Cardiovascular Division
Brigham and Women's Hospital
Boston, MA