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 - 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.

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.


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.