Refludan: Dosing - A Straight Forward Transition to Oral Anticoagulation

During conversion to oral anticoagulation, coumarin can be safely overlapped with ongoing REFLUDAN infusion¹

—	Small effect on INR when REFLUDAN is stopped ²

—	No complicated dosing calculations required during conversion¹

Oral anticoagulation therapy should be initiated only when platelet counts are normalizing and clinical status has improved

To avoid the potential prothrombotic effects of
coumarin therapy

Allow several days for coumarin to reach the desired therapeutic effect before discontinuing REFLUDAN^1, 3

—	May take 4 to 5 days (see oral anticoagulant package insert for information)

Monitoring should continue to ensure that the INR is stable

Additional notes

	Concomitant treatment with coumarin derivatives may increase risk of bleeding¹

	Coumarin derivatives are contraindicated as monotherapy in acute HIT because of their initial prothrombotic effects^3, 4