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In summary, the new oral anticoagulants represent a giant step forward in the quest to replace warfarin. In addition to their enhanced convenience, the new agents are not only safer than warfarin because of the reduced risk of intracranial bleeding, but they also have the potential to be more effective.
Warfarin is the oral anticoagulant most frequently used to control and prevent thromboembolic disorders. Prescribing the dose that both avoids hemorrhagic complications and achieves sufficient suppression of thrombosis requires a thorough understanding of the drug's unique pharmacology. Warfarin has a complex dose-response relationship that makes safe and effective use a challenge. For most indications, the dose is adjusted to maintain the patient's International Normalized Ratio (INR) at 2 to 3.