Starting dose for VKAs by age
| VKA . | Age . | Starting dose (mg/kg)∗ . | Frequency . |
|---|---|---|---|
| Warfarin | |||
| Standard | 0-18 y | 0.20 | Once daily |
| Fontan | 0-18 y | 0.10 | Once daily |
| Liver dysfunction | 0-18 y | 0.10 | Once daily |
| Acenocoumarol | |||
| 2 mo to 1 y | 0.20 | Once daily | |
| >1-5 y | 0.09 | Once daily | |
| 6-10 y | 0.07 | Once daily | |
| 11-18 y | 0.06 | Once daily | |
| Phenprocoumon (median dose) | |||
| <1 y | 0.15 | Once daily | |
| >1-5 y | 0.09 | Once daily | |
| 6-10 y | 0.13 | Once daily | |
| 11-18 y | 0.08 | Once daily | |
| Maintenance dosing for INR target range of 2.0-3.0 | |||
| INR | Adjustment | ||
| 1.1-1.4 | Increase dose by 20% | ||
| 1.5-1.9 | Increase dose by 10% | ||
| 2.0-3.0 | No change | ||
| 3.1-3.5 | Decrease dose by 10% | ||
| >3.5 | Hold until INR of <3.5, then restart at 20% of dose | ||
| VKA . | Age . | Starting dose (mg/kg)∗ . | Frequency . |
|---|---|---|---|
| Warfarin | |||
| Standard | 0-18 y | 0.20 | Once daily |
| Fontan | 0-18 y | 0.10 | Once daily |
| Liver dysfunction | 0-18 y | 0.10 | Once daily |
| Acenocoumarol | |||
| 2 mo to 1 y | 0.20 | Once daily | |
| >1-5 y | 0.09 | Once daily | |
| 6-10 y | 0.07 | Once daily | |
| 11-18 y | 0.06 | Once daily | |
| Phenprocoumon (median dose) | |||
| <1 y | 0.15 | Once daily | |
| >1-5 y | 0.09 | Once daily | |
| 6-10 y | 0.13 | Once daily | |
| 11-18 y | 0.08 | Once daily | |
| Maintenance dosing for INR target range of 2.0-3.0 | |||
| INR | Adjustment | ||
| 1.1-1.4 | Increase dose by 20% | ||
| 1.5-1.9 | Increase dose by 10% | ||
| 2.0-3.0 | No change | ||
| 3.1-3.5 | Decrease dose by 10% | ||
| >3.5 | Hold until INR of <3.5, then restart at 20% of dose | ||
Maximum starting dose, 10 mg.