Warfarin may be commenced but LMWH is also needed initially

Your supervising consultant, agrees that warfarin may be used to treat deep vein thrombosis and pulmonary embolism. He also agrees that warfarin cannot be used as monotherapy initially as its maximal pharmacological effects are not achieved until after at least 48 hours. Heparin bridging also prevents warfarin's early procoagulant effects.

Since this is a patient that needs immediate treatment, warfarin may be initiated together with low molecular weight heparin treatment. Kylie is expected to benefit more immediately by Factor Xa inhibition, mediated by LMWH. 

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