About UW Medicine Anticoagulation Services

This website contains UWMedicine recommendations, guidelines and protocols for the treatment and prevention of venous and arterial thrombosis, and the clinical use of antithrombotic agents in ambulatory and inpatient settings.

UWMedicine Anticoagulation Services is operated by the UWMedicine Department of Pharmacy, and collaborates with multidisciplinary specialties and providers  across UWMedicine to develop and disseminate guidelines and to coordinate the use of antithrombotic agents across the UWMedicine enterprise.  

UWMedicine Anticoagulation Services also provides management of anticoagulant therapy in pharmacist-managed anticoagulation clinics at the University of Washington Medical Center (UWMC) , Seattle Cancer Care Alliance (SCCA) and Harborview Medical Center (HMC).  Pharmacist providers in these clinics are involved in clinical practice, training and education, and research activities consistent with the mission of UW Medicine and the Department of Pharmacy.

"The goals of pharmacist-managed anticoagulation services include treatment and prevention of thromboembolic disease and minimization of complications of antithrombotic therapy."

Use the links to the left to navigate through the major sections of this site. The links at the top are the most frequently visited areas. BY USING THE SITE, YOU AGREE TO THE TERMS OF USE; IF YOU DO NOT AGREE, DO NOT USE THE SITE.

 

 

UPDATE - UW Medicine restriction for Apixaban use in CrCl < 30ml/min REMOVED

Due to recently published literature using apixaban in patients receiving three times a week hemodialysis and changes in practice, the restriction for use of apixaban in patients with CrCl < 30 ml/min has been removed. Eliquis prescribing information has also been updated to reflect this information. Continue to exercise caution when using apixaban in patients with renal dysfuction.

UPDATE - Guidelines for Reversing Coagulopathies in Patients with Symptomatic Spontaneous IPH

Updates to the Guidelines for Reversing Coagulopathies in Patients with Symptomatic Spontaneous IPH has been made. This changes Kcentra dosing from weight based to a fixed dose. The supporting reversal guides for warfarin and DOACs have been updated accordingly.

UPDATE - Patient education: Treatment with Enoxaparin

The patient education document "Treatment with Enoxaparin" has been updated with new formatting. No major changes to the content have been made at this time.

NEW - Andexanet Alfa (Andexxa)

Information on the new factor Xa inhibitor reversal agent has been added to the website. Although this medication is now FDA approved, quantities are limited and only available at certain institutions. Portola pharmaceutical has received approval for their Generation 2 manufacturing process on Dec 31st, 2018. The UW P&T Committee has decided NOT to add andexanet alfa to formulary. UW hospitals DO NOT have access to andexanet alfa at this time.

NEW PROGRAM - UWMC PERT

The new UWMC Pulmonary Embolism Response Team (PERT) begins on 6/26/18. Please see algorithms for diagnosis and treatment of massive/submassive PE, and for activation of the PERT, in the VTE/PE section of this website. 

REVISED GUIDELINES - Management of Antithrombotic Therapy for Neuraxial and Peripheral Nerve Procedures

In February 2018, Harborview Medical Center adopted new internal recommendations for management of antithrombotic therapy for selected lower extremity peripheral nerve procedures. UW Medicine guideline were updated to reflect these internal recommendations.

REVISED GUIDELINES - Recommendations for Chronic Antithrombotic Therapy

In March 2017, the American Heart Association/American College of Cardiology Task Force on Clinical Practice Guidelines published a focused update to the AHA/ACC guideline for management of patients with valvular heart disease. The UWMedicine Recommendations for Chronic Antithrombotic Therapy have been revised to reflect this focused update.

REVISED GUIDELINES - Guidelines for Reversing Coagulopathies in Patients with Symptomatic Spontaneous Intraparenchymal Hemorrhage

In February 2017, UWMedicine Guidelines for Reverse Coagulopathies in Patients with Symptomatic Intraparenchymal Hemorrhage and related algorithms were revised to reflect the availability of idarucizumab for reversal of dabigatran, edoxaban (a new factor Xa inhibitor) and the PATCH trial (Lancet 2016; 387:2605-13) investigating the role of platelet transfusion in IPH patients taking antiplatelet agents. 

REVISED GUIDELINES - Risk Stratification and Recommendations for Bridge Therapy in Patients on Warfarin

In January 2017, the American College of Cardiology published new recommendations for periprocedural management of anticoagulation in patients with nonvalvular AF.  These guidelines use the CHA2DS2-VASc score, rather than the CHADS2 score, to guide decision-making.  As a result, UWMedicine's Risk Stratification and Recommendations for Bridge Therapy in Patients on Warfarin has been revised.  

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