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Rebecca L. VAD Coordinator

Bridging for subtherapeutic INRs

Thu, 05/26/2016 - 5:22PM
At what point does your program bridge with lovenox or heparin for subtherapeutic INRs? (Ie 0.3 below goal range or less) Do you use full dose or half dose lovenox?
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andrew w.

Thu, 06/02/2016 - 7:50AM
Hi Rebecca, We use tinzaparin to bridge our patients with subtheraputic INR and our cut off for giving this in an INR less then 1.8. Hope this is helpful kind regards Andy Woods
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Johann H.

Fri, 06/03/2016 - 5:35AM
Rebecca, We use lovenox (60/80 mg depending on the BSA), if the INR is 0.1 below the therapeutic range (typical 2.0 to 2.5).
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Timothy R.

Mon, 01/16/2017 - 10:42AM
We use this method often. For our patients, a full dose Lovenox is been useful and had only 1 bleeding event (someone who bled badly from a peripheral IV site when taking the lovenox closer than prescribed to IV heparin). Either 1mg/kg q 12 or 1.5mg/kg/Q24 rounded to the nearest 10. Typically a course of 5 days with an INR check day 4. Never had a thrombotic event worsen while bridging.