Anticoagulation Management Service

Lowell General Hospital Anticoagulation Management Services (AMS) provides care for patients undergoing anticoagulation therapy. Currently managing over 1,100 patients a month from various specialties such as Cardiology, Orthopedics, Primary Care Physicians, and Oncology.

The AMS team closely monitors each patient’s treatment plan and follow up with prompt dosage adjustments when necessary. AMS helps provide better patient outcomes and provides counseling and comprehensive education to patients and the family members of those patients on blood thinner medications such as:

  1. Vitamin K Antagonists (a group of substances that reduce blood clotting by reducing the action of vitamin K):
    - Warfarin (Coumadin®)
    - Warfarin (Jantoven®)

  2. Direct Oral Anticoagulants (DOACs):
    - Apixaban (Eliquis®)
    - Dabigatran (Pradaxa®)
    - Edozaban (Savaysa®)
    - Rivaroxaban (Xarelto®)   


This medication, also known as Coumadin or Jantoven®, is a blood thinner that is used to treat blood clots and lower the chance of blood clots forming or moving. Blood clots can cause stroke, heart attack, or other serious conditions if formed in the leg or lungs. Warfarin is prescribed to those who have had a heart-valve replacement, atrial fibrillation, deep vein thrombosis (DVT), pulmonary embolism (PE), and excessive clotting (Hypercoagulable) Disorders.

Warfarin use must be closely monitored, as the degree of anticoagulation often changes depending on the patient’s diet, concurrent medications, and ongoing illnesses. This variability can lead to clot formation or bleeding. In order to maintain therapeutic balance, blood needs to be sampled routinely and appropriate adjustments in warfarin dose must be made.

Direct Oral Anticoagulants (DOACs)

These medications require a blood test for kidney function for proper dosing but do not require the degree of monitoring required by warfarin dosing. This class of medication should not be used for those patients who have undergone cardiac valve surgery.

Hours and Location

Anticoagulation Management Service
600 Clark Road
Tewksbury, MA

Monday-Friday 8:00 a.m. to 5:00 p.m.
Phone: 978-323-7005
Fax:  978-323-7010

Clinical Services & Programs

Conditions that may require anticoagulation therapy include:

  • Atrial Fibrilation
  • Acute Myocardial Infarction with Severe LV Dysfunction
  • Cardioembolic stroke
  • DVT
  • PE
  • Cerebral venous thrombosis
  • Hypercoagulable disorders
  • Valvular heart disease
  • Left ventricular dysfunction
  • Post-operative hip and knee surgery

Services provided

  • Finger blood testing
  • Ongoing patient assessment and education
  • Review and management of medication interactions
  • Blood test result interpretation
  • Adjustment of Warfarin dose  
  • Scheduling of next blood tests and followup
  • Counseling regarding: diet, possible interactions between Warfarin and other medications, vitamins, and herbal supplements, the effects of illness, and safety behaviors 

Your Care Team

Anticoagulation Management Services team
Anticoagulation Management Services team

The staff at AMS includes Dr. Mirit Ibrahim, MD, Medical Director of the AMS and cardiologist with Merrimack Valley Cardiology. Dr. Ibrahim creates the AMS specific guidelines utilizing the American College of Chest Physicians CHEST Guidelines, her peers and the Pharmacy and Therapeutics (P&T) Committee.

In addition, our team of registered nurses and support staff strive to provide Complete connected care by notifying physicians regarding concerns with their patients, and provide close follow up and monitoring around procedures and illness. The staff ensures a safe transition of care by tracking their patients when they are out of AMS’s care in hospitals, rehabilitation centers, or when a patient is out of state.

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