Which drug is considered the drug of choice for long-term anticoagulation after Heparin treatment?

Warfarin is considered the drug of choice for long-term anticoagulation after Heparin treatment primarily due to its well-established role in managing various conditions requiring long-term blood thinning. It has been used for decades and offers the ability to adjust the dosage based on therapeutic INR levels, allowing for precise control of coagulation. This makes it suitable for patients who are transitioning from the immediate effects of Heparin, which is a short-acting anticoagulant, to a longer-term management strategy.

In contrast, while Rivaroxaban and Apixaban are also anticoagulants that can be used long-term, they do not require the same level of monitoring and have different mechanisms of action compared to Warfarin. These direct oral anticoagulants (DOACs) tend to be chosen in specific situations where their profile fits the patient's needs, but Warfarin remains the traditional choice, especially in patients who may already be accustomed to its regimen.

Enoxaparin is a low molecular weight heparin primarily used for short-term anticoagulation, especially in hospital settings or during acute phases of treatment, but it is not typically used for long-term anticoagulation once Heparin therapy has ended.

Thus, Warfarin remains