What is the primary monitoring concern when prescribing warfarin?

The primary monitoring concern when prescribing warfarin is related to bleeding complications and INR levels. Warfarin is an anticoagulant that works by inhibiting vitamin K-dependent clotting factors, which increases the risk of bleeding. Therefore, monitoring the International Normalized Ratio (INR) is crucial to assess the effectiveness of the anticoagulation and to ensure that the blood's ability to clot is within a safe range. This helps prevent both over-anticoagulation, which can lead to hemorrhagic complications, and under-anticoagulation, which can result in thromboembolic events.

Close monitoring of INR allows healthcare providers to adjust the dose of warfarin appropriately. The goal is to maintain INR within a therapeutic range, typically between 2.0 and 3.0 for many indications, although the exact range may vary depending on the clinical scenario. By focusing on INR levels and the potential for bleeding complications, healthcare providers can effectively manage the risks associated with warfarin therapy and optimize patient safety.