East Region Formulary
NHS Scotland

Anticoagulation

Refer to local hospital guidelines for anticoagulation and thromboprophylaxis. See separate formulary recommendations for Pulmonary embolism, Venous thromboembolism, Atrial fibrillation and Acute coronary syndrome. 

Anticoagulation - prevention and treatment of thrombotic events

Prescribing Notes:

  • Refer to local guidelines and/ or contact relevant specialist for advice.  
  • Medicine choices are directed by a specialist prescriber experienced in the management of the condition being treated, use is in line with relevant local or national guidance.
  • If parenteral anticoagulation is required, choices include a LMWH or unfractionated heparin.
  • For oral anticoagulation choices include a direct oral anticoagulant. In selected patient groups warfarin may be required.
  • For more information refer to National Patient Safety Alert – ‘Inappropriate anticoagulation of patients with a mechanical heart valve’. Supporting information has been prepared to support identification of valve type when reviewing patients. 

History Notes

06/10/2025

Prescribing information updated, ERFC Sept 2025

Anticoagulation in patients with heparin-induced thrombocytopenia type II who require parenteral antithrombotic therapy
Argatroban
Argatroban 50mg/50ml solution for infusion vials

See product literature or local guidelines.

Fondaparinux
Fondaparinux sodium 1.5mg/0.3ml solution for injection pre-filled syringes

See product literature or local guidelines.

Fondaparinux sodium 2.5mg/0.5ml solution for injection pre-filled syringes

See product literature or local guidelines.

Fondaparinux sodium 5mg/0.4ml solution for injection pre-filled syringes

See product literature or local guidelines.

Fondaparinux sodium 7.5mg/0.6ml solution for injection pre-filled syringes

See product literature or local guidelines.

Fondaparinux sodium 10mg/0.8ml solution for injection pre-filled syringes

See product literature or local guidelines.

Prescribing Notes:

  • Refer to local guidelines and/or contact relevant specialist for advice.

History Notes

06/10/2025

Prescribing information updated, ERFC Sept 2025

Anticoagulation – heart conditions and prosthetic heart valves
Warfarin
Warfarin 500microgram tablets

For dose, refer to BNF for Children.

Warfarin 1mg tablets

For dose, refer to BNF for Children.

Warfarin 3mg tablets

For dose, refer to BNF for Children.

Warfarin 5mg tablets

For dose, refer to BNF for Children.

Prescribing Notes:

  • The warfarin dose is adjusted according to the international normalised ratio (INR). The target INR should be clearly identified at initiation of therapy, and measured daily or on alternate days initially, then at longer intervals (depending on response) then up to every 12 weeks.
  • Indication and duration of treatment should be clearly recorded at initiation of treatment; the patient-held anticoagulant treatment booklet should be used. See BNFc for details.
  • The plasma half-life of warfarin is 35 hours; a steady anticoagulant effect is achieved after about one week. If immediate anticoagulation is required, heparin or LMWH must be given concomitantly.
  • There are many clinically important interactions with warfarin; clinicians are strongly advised to consult BNFc before prescribing.
  • Vitamin K (phytomenadione) can be given to reverse the effects of warfarin but takes 6-12 hours to become effective. Immediate reversal of the anticoagulant effect of warfarin may be achieved with prothrombin complex concentrate or (if no concentrate available) fresh frozen plasma; see BNFc for details. Specialist haematological advice should be sought.
  • Cardiac patients on warfarin should have doses adjusted by cardiology consultants.

History Notes

19/06/2023

East Region Formulary content agreed - ERFC 07/06/2023.