About UW Medicine Anticoagulation Services

This website contains UW Medicine 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.

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

UW Medicine 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 - New UW Medicine Anticoagulation Clinic Referral Form

The UW Medicine Anticoagulation Clinic referral form has been updated to include UWMC Northwest Anticoagulation Clinic. Please access site here

UPDATE - DOAC Patient Education

Patient education handouts for apixaban, dabigatran, and rivaroxaban have been updated and can be accessed here.

NEW - Transition to Anti-Xa Monitoring of Heparin

After much discussion and consideration that included many different stakeholders and content experts, UW Medicine will - starting on Oct 29, 2019 - use anti-Xa activity instead of PTT to adjust heparin doses when continuous IV heparin is ordered as a nurse-managed infusion. Algorithms can be viewed here. This change is important and is being implemented because:

VTE Prophylaxis Updates - Heparin Shortage

In light of the national heparin shortage and lack of evidence supporting superior outcomes with TID vs. BID SQ heparin, changes have been made to the UW Medicine VTE prophylaxis guidelines to conserve heparin. Please see below for recommended alternatives:

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

Updates to the Guidelines for Reversing Coagulopathies in Patients with Symptomatic Spontaneous IPH have been made. Changes reflect laboratory tests which replaces PTT with anti-Xa levels. 

UPDATE - Chronic Antithrombotic Therapy Guidelines

Recommendations for chronic antithrombotic therapy have been updated with changes from the most recently published guidelines. See our updated page for more information.

UPDATE - Suggestions For Warfarin Management Before And After Invasive Procedures

Through ongoing review of our current practices and concerns for over anticoagulation around invasive procedures our current guidelines have changed. A new CrCl group has been created to more accurately capture how changes in renal function impact LMWH clearance. See our update page for more information.

NEW - HMC PE Response Team (PERT) algorithm and information has been added

The HMC PERT diagnosis algorithm and program information has now been added. See this link for more information.

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.