What starting dose was recommended for warfarin in its early days?

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What starting dose was recommended for warfarin in its early days?

  • Less than 1 mg daily

    Votes: 2 18.2%
  • 2 to 5 mg daily

    Votes: 5 45.5%
  • 6 to 10 mg daily

    Votes: 0 0.0%
  • 11 to 20 mg daily

    Votes: 2 18.2%
  • 21 to 50 mg daily

    Votes: 1 9.1%
  • More than 50 mg daily

    Votes: 1 9.1%

  • Total voters
    11
G

Guest

I just found a reference from my pharmacy school days giving a recommended starting dose for warfarin.
 
I am guessing on the conservative side (less than 1mg) but it would not surprise me that it is higher. My starting does in 1980 was 5mg.
 
My guess was very low- under 1 mg- since the early days seemed to be where all the myths come from about taking too much coumadin? I started really low in the hospital, cant remember exactly, but i know it was under 3mgs. HA! now im at 12.5- no wonder it too so long to get in range!
 
60 (sixty) (six-zero) mg per day. Can you believe it. This is why people bled to death. This is from the same pharmacology book that medical students were using.

After the inital dose they then recommended maintaining it at 10 mg per day.

RCB said that when he went home from his valve surgery in 1960 they told him that if he peed blood then back the dose off some.

Now that should hold the record for po'd!!!!!!!!

Research in those days consisted of passing out samples of the drug and asking the doctors to write to the manufacturer if they had any problems.

However, in 1960 it probably didn't matter much if a valve patient was overdosed because in September 1960 it was estimated that the life expectancy of someone who got a mechanical valve was less than two MONTHS. That is correct ladies and gentlemen - you could expect to live just about long enough after you got a valve to get your will notarized.
 
Why were people only living 2 months after the mechanical valves? That is really disturbing- more so than the 60 mgs of coumadin per day. What was wrong with the mechanical valves 48 years ago?
 
Why were people only living 2 months after the mechanical valves? That is really disturbing- more so than the 60 mgs of coumadin per day. What was wrong with the mechanical valves 48 years ago?


Pretty disturbing stuff huh?

I remember back in 75' when I had my mechanical double-valve implants, hearing one of the cardiologists say that the valves (my new implanted valves) were only suppose to last 10 years!!!! :eek: Imagine how that must have sounded to already scared out of her mind, 24-year old???


But on a lighter note, I guess I proved some of those people wrong!!!
 
My Dad was on coumadin in 1962 and lived for two years. He did not have valve/heart surgery. I don't know the specific reason coumadin was prescribed but my father suffered a series of heart attacks prior to and while on coumadin. Was it prescribed back then for a-fib?
 
The heavy dose (60mg) may have been administered while I was in the hospital, but I doubt that I went home on that dosage. The 10mg probably is more in line and I took 7.5 to 10mg for many years.

To MNmom: Remember that this technology was brand new in 1960 and the first patients would have been on deaths door. I remember talking with a cardiologist in 1961/1962 about the new surgery to correct valve defects like mine. His response was that it was too new and the risk was too great. By 1966 a lot changed and the cardiologists were telling me that the risk of NOT having the surgery far outweighed the 4/5% risk of dying during surgery. They also told me the mechanical valve would last 50 years and that I would be able to do almost anything I wanted to do. They were right.
 
Then again, in 1960, open heart surgery was still new and I'm sure you didn't have that good of a chance with the technology back then of coming out of the surgery alive.

I guess we can look at the valve replacement (fairly new) in the 1960's to artificial heart recipients now days (still in its infancy). I'm sure in 20 years, there will be a group like VR talking about the early life expectancy of the artificial heart.
 
In 1960 the only diagnostic tool for valve failure was a stethoscope. Which by the way was invented by a pharmacist. This caused the doctors to ask why anyone would want to listen to the inside of someone's body.
 
Thanks, Al.

Some things haven't changed.
First notice of valve problem today is still the stethoscope.......
First I knew I had a problem was when PCP heard my 'never heard before' murmer.
 

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