Warfarin in non-valvular atrial fibrillation

Anthony J Dalby, Pieter Wessels, Lionel H Opie


The development of novel oral anticoagulants that are effective alternatives to warfarin in non-valvular atrial fibrillation (AF) is a welcome advance. However, a variety of unresolved problems with their use, and not least with their cost, make it important to re-evaluate the use of warfarin as it will likely remain the anticoagulant of choice in South African patients with non-valvular AF for the foreseeable future. In this article, we review the correct clinical use of warfarin. Guidance is provided on commencing warfarin treatment, maintenance dosing, the recommended steps when temporary withdrawal of treatment is necessary, the management of bleeding, and the use of warfarin in chronic kidney disease. Techniques for changing from warfarin to one of the new oral anticoagulants and vice versa are included. 

Authors' affiliations

Anthony J Dalby, Cardiologist in Private Practice, Milpark Hospital, Johannesburg, South Africa

Pieter Wessels, Ampath Laboratories, Pretoria, South Africa

Lionel H Opie, Hatter Institute for Cardiovascular Research in Africa, Faculty of Health Sciences, University of Cape Town, South Africa

Full Text



anitcoagulants; warfarin; non-valvular atrial fibrillation

Cite this article

South African Medical Journal 2013;103(12):901-904. DOI:10.7196/SAMJ.7172

Article History

Date submitted: 2013-06-18
Date published: 2013-10-11

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