Argatroban + warfarin

Argatroban + warfarin is a combination anticoagulant therapy used primarily for the management of patients with heparin-induced thrombocytopenia (HIT) who require oral anticoagulation. Argatroban is a small molecule direct thrombin inhibitor that reversibly binds to the active site of thrombin, inhibiting both free and clot-associated thrombin, thereby preventing fibrin formation, activation of coagulation factors V, VIII, XIII, protein C activation, and platelet aggregation[4][6]. Warfarin is a vitamin K antagonist that inhibits the synthesis of vitamin K-dependent clotting factors II, VII, IX, and X in the liver. The combination is used during transition from parenteral to oral anticoagulation; overlap therapy ensures continuous anticoagulation as warfarin’s onset is delayed. Co-administration results in increased prothrombin time (PT) and international normalized ratio (INR), requiring careful monitoring due to altered INR interpretation[1][3][5].

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