The effectiveness of split tablet dosing versus alternate-day dosing of warfarin: a randomized control trial

Abstract Due to large dosage variation, a variety of warfarin prescription regimens are utilized for specific doses such as tablet splitting, or pill strength alternating. The clinical comparison between the two is lacking. We hypothesize that both approaches result in different times in therapeutic...

Full description

Saved in:
Bibliographic Details
Main Authors: Chanyapat Kaewsaengeak, Usanee Pienputtarapong, Teerapong Tocharoenchok
Format: Article
Language:English
Published: Nature Portfolio 2021-12-01
Series:Scientific Reports
Online Access:https://doi.org/10.1038/s41598-021-03606-z
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849432591731523584
author Chanyapat Kaewsaengeak
Usanee Pienputtarapong
Teerapong Tocharoenchok
author_facet Chanyapat Kaewsaengeak
Usanee Pienputtarapong
Teerapong Tocharoenchok
author_sort Chanyapat Kaewsaengeak
collection DOAJ
description Abstract Due to large dosage variation, a variety of warfarin prescription regimens are utilized for specific doses such as tablet splitting, or pill strength alternating. The clinical comparison between the two is lacking. We hypothesize that both approaches result in different times in therapeutic range. We randomized patients with specific warfarin dosage and stable INR for 6 months or longer to receive the whole tablet, alternate-day dosing or the split tablet, same daily-dosing regimen without initial dose change and followed them every 6 weeks for 6 months. The primary outcome was a time in therapeutic range of 2.0–3.0. The secondary outcomes included dosage, compliance, INR, anticoagulant-related events. A total of 66 patients were enrolled, 32 randomly assigned to the split tablet regimen (group S) and 34 to the alternate-day regimen (group A) with two withdrawers. The mean age was 58.6 ± 8.5 years. All baseline characteristics of both groups were similar. The average time in therapeutic range was 72.8 ± 25.4% in group S and 74.9 ± 22.0% in group A (p = 0.72). There were no significant differences in warfarin dosage, compliance, INR and, complications between the two groups. Both warfarin prescription methods, the split tablet and the alternate-day had comparable time in the therapeutic range.
format Article
id doaj-art-d95f0f0cef974edf9f7e8515bb3ffa0a
institution Kabale University
issn 2045-2322
language English
publishDate 2021-12-01
publisher Nature Portfolio
record_format Article
series Scientific Reports
spelling doaj-art-d95f0f0cef974edf9f7e8515bb3ffa0a2025-08-20T03:27:18ZengNature PortfolioScientific Reports2045-23222021-12-011111610.1038/s41598-021-03606-zThe effectiveness of split tablet dosing versus alternate-day dosing of warfarin: a randomized control trialChanyapat Kaewsaengeak0Usanee Pienputtarapong1Teerapong Tocharoenchok2Department of Surgery, Police General HospitalAmbulatory Care Unit, Pharmacy Department, Faculty of Medicine Siriraj Hospital, Mahidol UniversityDivision of Cardiothoracic Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol UniversityAbstract Due to large dosage variation, a variety of warfarin prescription regimens are utilized for specific doses such as tablet splitting, or pill strength alternating. The clinical comparison between the two is lacking. We hypothesize that both approaches result in different times in therapeutic range. We randomized patients with specific warfarin dosage and stable INR for 6 months or longer to receive the whole tablet, alternate-day dosing or the split tablet, same daily-dosing regimen without initial dose change and followed them every 6 weeks for 6 months. The primary outcome was a time in therapeutic range of 2.0–3.0. The secondary outcomes included dosage, compliance, INR, anticoagulant-related events. A total of 66 patients were enrolled, 32 randomly assigned to the split tablet regimen (group S) and 34 to the alternate-day regimen (group A) with two withdrawers. The mean age was 58.6 ± 8.5 years. All baseline characteristics of both groups were similar. The average time in therapeutic range was 72.8 ± 25.4% in group S and 74.9 ± 22.0% in group A (p = 0.72). There were no significant differences in warfarin dosage, compliance, INR and, complications between the two groups. Both warfarin prescription methods, the split tablet and the alternate-day had comparable time in the therapeutic range.https://doi.org/10.1038/s41598-021-03606-z
spellingShingle Chanyapat Kaewsaengeak
Usanee Pienputtarapong
Teerapong Tocharoenchok
The effectiveness of split tablet dosing versus alternate-day dosing of warfarin: a randomized control trial
Scientific Reports
title The effectiveness of split tablet dosing versus alternate-day dosing of warfarin: a randomized control trial
title_full The effectiveness of split tablet dosing versus alternate-day dosing of warfarin: a randomized control trial
title_fullStr The effectiveness of split tablet dosing versus alternate-day dosing of warfarin: a randomized control trial
title_full_unstemmed The effectiveness of split tablet dosing versus alternate-day dosing of warfarin: a randomized control trial
title_short The effectiveness of split tablet dosing versus alternate-day dosing of warfarin: a randomized control trial
title_sort effectiveness of split tablet dosing versus alternate day dosing of warfarin a randomized control trial
url https://doi.org/10.1038/s41598-021-03606-z
work_keys_str_mv AT chanyapatkaewsaengeak theeffectivenessofsplittabletdosingversusalternatedaydosingofwarfarinarandomizedcontroltrial
AT usaneepienputtarapong theeffectivenessofsplittabletdosingversusalternatedaydosingofwarfarinarandomizedcontroltrial
AT teerapongtocharoenchok theeffectivenessofsplittabletdosingversusalternatedaydosingofwarfarinarandomizedcontroltrial
AT chanyapatkaewsaengeak effectivenessofsplittabletdosingversusalternatedaydosingofwarfarinarandomizedcontroltrial
AT usaneepienputtarapong effectivenessofsplittabletdosingversusalternatedaydosingofwarfarinarandomizedcontroltrial
AT teerapongtocharoenchok effectivenessofsplittabletdosingversusalternatedaydosingofwarfarinarandomizedcontroltrial