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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.



Site Errors

We have been experiencing some instability with the site, and you may see error messages occasionally. If you do get an error, refresh the page and it will usually load. It may take a couple of refreshes sometimes. We are working on a new site, and hope to have it up soon.

NEW - DOAC to IV Heparin Transition

New guidance have been created for patients who had been taking oral factor Xa inhibitors requiring inpatient transition to intravenous heparin. Guidance can be found here

UPDATE - Changes to Bivalirudin Initial Dosing

Based on review of internal data as well as most recent literature, patients receiving renal replacement therapy are now recommended to start bivalirudin at a rate of 0.05 mg/kg/hr (previously 0.02 mg/kg/hr). New dosing recommendations can be accessed here

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.