Anticoagulation Therapy

If you have a mechanical heart valve, you will be prescribed daily anticoagulation (often called blood thinner) therapy. Some patients with tissue valves may also need anticoagulant treatment – usually the first three months after implant -- or longer if other medical conditions arise that need anti-clotting therapy.

Anticoagulants alter the clotting mechanism of your blood to prevent formation of a thrombus (a blood clot attached to tissue).  They can also be used to treat a thrombus before it becomes larger and breaks off to circulate through the body.

Warfarin (Coumadin®) is the most commonly prescribed anticoagulant and is given orally. It is a frequently prescribed medication. Other anticoagulants are given by injection and, in general, used only temporarily. Injected anticoagulants include heparin, low-molecular-weight-heparin (LMWH), and direct thrombin inhibitors.

Dosing and Your INR

To determine the proper dose of warfarin, your physician will perform a blood test to measure your prothrombin time – the amount of time it takes for your blood to clot. The ideal dose should prevent blood clots but not increase risks of serious bleeding problems. Testing will give you an INR (international normalized ratio), a number that indicates your optimum therapeutic range for your warfarin. This range varies among individuals.

You and your doctor will monitor your INR regularly to ensure that you are receiving the appropriate dosage.

INR Monitoring

If you are taking warfarin, it is important to stay within your INR (international normalized ratio), a number that indicates the optimum therapeutic range for your dosage.

You will need regular monitoring of your INR, which may include monthly blood tests at your physician’s office, clinic, special lab, or at home. More frequent monitoring may be required if you undergo significant changes in your diet, medications, or general health.

Home INR Monitoring

Home INR monitoring is also available, providing an option for reliable testing in the comfort and convenience of your home.

Benefits of home INR monitoring include:

• Greater control over your own care
• The ability to test INR more frequently
• No driving to labs or clinics
• No waiting for results
• More careful tracking of results
• Help in the decision-making process for dose adjustments

Many home INR monitoring programs offer training and assistance in areas such as health insurance reimbursement.