What is the primary concern when prescribing Warfarin?

The primary concern when prescribing Warfarin is the risk of bleeding complications. Warfarin is an anticoagulant that works by inhibiting vitamin K-dependent clotting factors, which leads to a decrease in the blood's ability to clot. This heightened risk for bleeding can occur in various forms, including gastrointestinal bleeding, intracranial hemorrhages, and excessive bleeding from cuts or injuries.

Patients on Warfarin need careful monitoring of their International Normalized Ratio (INR) levels to ensure they remain within the therapeutic range, as fluctuations can lead to either insufficient anticoagulation, increasing the risk of thromboembolic events, or excessive anticoagulation, leading to serious bleeding.

While renal toxicity, gastrointestinal upset, and potential liver damage can be concerns with many medications, they are not the primary focus when it comes to managing patients on Warfarin. The emphasis on monitoring and managing bleeding risk is fundamental to safe therapeutic practices with this medication.