warfarin + heparin

Warfarin plus heparin is a combination of two anticoagulant drugs used together to prevent and treat blood clots, especially in conditions such as deep vein thrombosis, pulmonary embolism, atrial fibrillation, and after certain surgeries. This combination is commonly used during the initial phase of anticoagulation therapy because warfarin (an oral vitamin K antagonist) takes several days to reach therapeutic effect, while heparin (an injectable indirect thrombin inhibitor) acts rapidly. Heparin is typically administered first for immediate anticoagulation; warfarin is started concurrently and continued long-term once its effect is established. Warfarin inhibits the synthesis of vitamin K-dependent clotting factors II, VII, IX, and X by antagonizing vitamin K epoxide reductase in the liver. Heparins potentiate antithrombin III activity to inhibit thrombin (factor IIa) and factor Xa[1][4][5][3]. The main risk with this combination is increased bleeding.

Brand names

Coumadin + HeparinJantoven + HeparinHep-Lock + Warfarin

Other names

warfarina + heparina4-hydroxy-3-(3-oxo-1-phenylbutyl)coumarin + unfractionated heparinzoocoumarin + eparina