For example, some manufacturers may recommend, in the patient information leaflet, that a medicine is not given to children aged under 12 years. A few products do not have a marketing authorisation (licence) as a medicine and therefore there is no PIL.įor children in particular, there may be conflicts of information between the manufacturer’s patient information leaflet (PIL) and guidance provided by GOSH and other healthcare providers. If you do not have a copy of the manufacturer’s patient information leaflet please talk to your pharmacist. Please read this information sheet from GOSH alongside the patient information leaflet (PIL) provided by the manufacturer. This can either be administered by health care professionals or you can learn to administer this yourself. If this is required for your child, we will discuss this with you. This is normally in the form of a Low Molecular Weight Heparin (dalteparin) which is administered as an injection – normally twice a day. In some cases, if an INR drops too low, the risk of a clot developing may be considered too great and so a second form of anticoagulation may be required. Behavioural changes – suggestive of a stroke.Pains in the legs or chest can be a symptom of a clot.This risk will relate to the reason they are on warfarin and not all the symptoms will apply to your child. If your child’s INR is below your target range they are at an increased risk of developing a clot. If you see any of these signs or other unexpected or unexplained signs, you should do an INR check and ask your healthcare provider/ Anticoagulation Team for advice. Bleeding after a cut that can take a little longer to stop.Bleeding gums (consider using a softer toothbrush).Nosebleeds that last longer than 5 to 10 minutes or frequent nose bleeds (see section on management).Warfarin and target INRĭo not stop giving warfarin, but contact your Anticoagulation Team to discuss. The higher the number, the longer it takes the blood to clot. A normal INR (without warfarin) is reflected as 1. The blood sample used to measure the effect of warfarin is called the INR (International Normalised Ratio). The only way to test how the treatment is working is by taking a blood sample and seeing how long it takes the blood to clot. All this needs to be taken into account when deciding on the dose of warfarin. This means that a change in dose will not be reflected in the blood test until this time. The effects of warfarin can last quite a long time in the body but it takes about two to four days to see these effects. Vitamin K is naturally present in food and milk.Įverybody reacts differently to warfarin so the dose must be worked out each time for every patient. It is a ’Vitamin K antagonist‘, which means it prevents a group of clotting proteins (which need Vitamin K to make them active) from doing their job fully. This is so you can have an INR tested or your dose of warfarin changed if needed.Warfarin works by slowing down the blood clotting process. It is important to tell your provider about any of the changes below. There are some things that may change your INR. Call your health care provider if you can't make a visit so you can reschedule. It is very important to have your blood drawn when you are told to. If your dose changes you may need to have your INR tested more often. When your INR and warfarin dose are stable, blood tests are often done every 2 to 4 weeks, sometimes longer. When you first start warfarin, you may need to have blood tests every few days or weekly. This keeps you safe from bleeding and making clots. Blood tests are done so your provider will know if you are taking the right dose. This is why your blood needs to be tested often. If your INR is below your range, you may be at a higher risk for making a blood clot.If your INR is above your range, you may be at a higher risk for bleeding.If your INR stays within your range, your chance of bleeding or getting a clot is small.Keeping your blood from clotting is a delicate process that is watched closely by your provider. Your provider may also report your prothrombin time, which is also called protime (PT). This blood test is called an International Normalized Ratio (INR). To find out how fast your blood clots, a small amount of your blood will be tested.
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