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Since warfarin initially decreases protein C levels faster than the coagulation factors, it can paradoxically increase the blood's tendency to coagulate when treatment is first begun (many patients when starting on warfarin are given heparin in parallel to combat this), leading to massive thrombosis with skin necrosis and gangrene of limbs

Whether you're new to trigger point injections or continuing an existing routine, our providers take a conservative, evidence-informed approach and explain every step no pressure, just honest guidance and provider-led care

If tolerance is good and no concerning reactions occur, consider increasing to twice-daily application or moving to a 1 percent concentration