Anticoagulation Centre
The Royal Children's Hospital Anticoagulation Service is the only dedicated paediatric anticoagulation service in Australia. The service provides specialist care for infants and children requiring various forms of anticoagulant therapy. The Anticoagulation Service consists of Consultant Haematologists, Haematology Registrars and a Clinical Nurse Consultant.
Clinics
Clinics are held on Friday's and appointments can be made by calling 9345 4398.
Anticoagulation Prescriptions
Patients referred to the Anticoagulation Service are provided with a prescription for their required medication at the time of referral or discharge from hospital. If families require an ongoing prescription for anticoagulant medications, they can contact the Anticoagulation Service directly on 9345 5827 to request a repeat prescription. Prescriptions supplied by the Anticoagulation Service can be filled at any pharmacy in Australia.
Outpatient Warfarin Management
Warfarin is an anticoagulant medication that is taken once a day in tablet form. Warfarin is the most commonly prescribed oral anticoagulant medication used at the Royal Children's Hospital, within Australian, and around the rest of the world. Patients taking warfarin require regular blood tests (called an International Normalized Ratio or INR) to ensure that the anticoagulant effect of warfarin is working just how we want it to. These blood tests may be required quite frequently during the first weeks of treatment, but can be extended out to every 4 weeks, if the anticoagulant level in patients' blood is stable. Every time a blood test is performed, the dose of warfarin the child is taking is reviewed to determine if it is still appropriate. Warfarin can be difficult to manage, however with specialist care, it can be managed safely and effectively.
The Warfarin Management program offered by the Anticoagulation Service has been in operation since 1999. Since that time, the Warfarin Management program has looked after over 200 children requiring warfarin therapy. Our outcomes with respect to the safety and efficacy of warfarin therapy in our patients are amongst the best in the world.
Information for families/community
It is not common for children who have been perfectly well to require anticoagulant therapy. Most children prescribed an anticoagulant medicine will have some kind of underlying health problem. It is therefore not possible to discuss within this site the finer details of managing anticoagulant therapy, as the patients requiring it can be very different. If you have any questions regarding your child's anticoagulant therapy, please contact us directly, or if your child's therapy is being managed somewhere else, contact the medical team looking after them.
There are 3 anticoagulant medications that are most frequently prescribed to infants and children. The choice of anticoagulant is very much dictated by the clinical condition of the patient and their indication for anticoagulation. The table below provides a simply summary of these drugs.
| Drug Name | How it is given | Indication |
| Standard Heparin | Into a vein via a drip or as an injection under the skin (subcutaneous) | Short-term treatment or prevention of unhealthy blood clots. |
| Clexane (Low Molecular Weight Heparin) | By an injection under the skin (Subcutaneous) | Medium-term (up to 3 months) treatment or prevention of unhealthy blood clots. |
| Warfarin | Oral (only available in tablet form) | Long-term treatment or prevention of unhealthy blood clots. |
Information for residents/registrars
The Anticoagulation Clinical Practice Guideline contains information on:
- Standard (Unfractionated ) Heparin Intravenous Infusion.
- Low Dose Standard Heparin.
- Prophylactic Subcutaneous Heparin.
- Low Molecular Weight Heparin.
- Blocked Central Venous Lines.
- Systemic Lytic Therapy
- Aspirin Therapy
- Warfarin Therapy
Referral to the Clinical Haematology Unit for advice regarding the management of paediatric thrombosis/anticoagulation can be made by contacting the Inpatient Haematology Registrar via the RCH switchboard