Bridging Medication

Publication Date: 
Tue, 11/08/2011
By: Alere Staff

“Bridging” is a term used in medicine where medications like warfarin are either temporarily stopped or reduced significantly before a procedure. Some typical procedures include: voluntary surgery, dental procedures and GI scoping. Many older patients face procedures that can cause an increase in bleeding. For patients on warfarin, the risks are even higher.

Healthcare providers want to perform surgical procedure without placing patients at unnecessary risk. If the risk of blood clots is very high, for mechanical heart valve patients as an example, clinicians may keep patients on warfarin but at a lower International Normalized Ratio (INR). If patients are at relatively low risk for blood clots, warfarin may be discontinued a day or two before the procedure and a day or so after. Clinicians use specific guidelines to determine the lowest risk for patients.

A “go “or “no go” decision to perform surgery is dependent on where the patient’s INR is the day of surgery. Rescheduling a procedure causes additional expenses, stress and the potential for further disease progression. Patients may also test their own INR at home and communicate the results to his/her healthcare team.

Determining if an INR test results are increasing or decreasing will determine if the procedure date will stick or if it will need to be rescheduled. Bridging is a short term but important time for patients. If you have questions about bridging warfarin because of an upcoming medical procedure, talk to your doctor.