Warfarin pharmacology, clinical management, and evaluation of hemorrhagic risk for the elderly

Elderly patients as a group may present more of a challenge in managing warfarin therapy because of alterations in pharmacokinetics from other medications, diet, and disease; pharmacodynamic changes; increased risk for hemorrhage; and difficulty in monitoring. The elderly, however, may derive the most benefit from warfarin therapy for certain indications, such as the prevention of stroke in atrial fibrillation or recurrent events following deep venous thrombosis, because their risk of thromboembolic disease is often significantly greater than that observed in other populations. Warfarin can be managed as effectively as in other populations with careful attention to these issues.