Table. Warfarin Initiation (for patient with average daily dose of 3 mg and target INR >1.6)

    DAY
    INR
    DOSE
    INPATIENT
    (Usually with daily INR)
    		 OUTPATIENT
    1
    		 Normal
    3.0 mg
    ( 1.5 or 3.0-6.0 mg in patients listed in the text )
    		3.0 mg
    ( 1.5 or 3.0-6.0 mg in patients listed in the text )
    2

    < 1.3
    > 1.3
    3.0 mg
    0.0 - 1.5 mg
    		 3.0 mg
    0.0 - 1.5 mg
    . . [If INR is not measured
    3.0 mg (1.5-4.5)]
    3
    < 1.3
    1.3 - 1.6
    1.6 - 2.6
    > 2.6
    3.0 - 6 mg
    1.5 - 3.0 mg
    0.0 - 1.5 mg
    0.0 mg
    		 3.0 - 6 mg
    1.5 - 3.0 mg
    0.0 - 1.5 mg
    0.0 mg

    .

    .

    		 INR should be measured today. If INR is not measured, may use the same dose as day 2, and should not > 3.0 mg
    4
    <1.3
    1.3 - 1.6
    1.6 - 2.6
    > 2.6
    4.5 - 6.0 mg
    3.0 - 4.5 mg
    1.5 - 3.0 mg
    0.0 mg
    		 4.5 - 6.0 mg
    3.0 - 4.5 mg
    0.0 - 3.0 mg
    0.0 mg
    . . INR measurement should be done, if INR on day 3 is <1.3 or >2.6
    5
    < 1.3
    1.3 - 1.6
    1.6 - 2.6
    > 2.6
    6.0 - 7.5 mg
    3.0 - 4.5 mg
    1.5 - 3.0 mg
    0.0 mg
    		 6.0 - 7.5 mg
    3.0 - 4.5 mg
    1.5 - 3.0 mg
    0.0 mg
    . . INR measurement should be done, if INR on day 4 is <1.3 or >2.6
    6
    < 1.3
    1.3 - 1.6
    1.6 - 2.6
    > 2.6
    6.0 - 7.5 mg
    4.5 - 6.0 mg
    1.5 - 3.0 mg
    0.0 mg
    		 6.0 - 7.5 mg
    4.5 - 6.0 mg
    1.5 - 3.0 mg
    0.0 mg
    . . INR measurement should be done, if INR on day 5 is <1.3 or >2.6
    Note: Frequent INR measurement during warfarin initiation helps prevent bleeding from over anticoagulation and helps reaching target INR sooner.