Slow induction regimen with warfarin
| Day 5 INR | Dose (for days 5–7) | Day 8 INR | Dose (from day 8) |
|---|---|---|---|
| Derived from Tait and Sefcick.35 The regimen relies on a baseline INR <1.4, warfarin dose 5 mg daily for first 4 days, INR result on day 5 predicting the warfarin dose on day 5–7, and INR result on day 8 predicting the warfarin dose on day 8 and beyond. | |||
| At day 15 (or day 12), check INR and make fine dose adjustment as appropriate. | |||
| ⩽1.7 | 5 mg | ⩽1.7 | 6 mg |
| 1.8–2.4 | 5 mg | ||
| 2.5–3.0 | 4 mg | ||
| >3.0 | 3 mg for 4 days | ||
| 1.8–2.2 | 4 mg | ⩽1.7 | 5 mg |
| 1.8–3.4 | 4 mg | ||
| 2.5–3.0 | 3.5 mg | ||
| 3.1–3.5 | 3 mg for 4 days | ||
| >3.5 | 2.5 mg for 4 days | ||
| 2.3–2.7 | 3 mg | ⩽1.7 | 4 mg |
| 1.8–2.4 | 3.5 mg | ||
| 2.5–3.0 | 3 mg | ||
| 3.1–3.5 | 2.5 mg for 4 days | ||
| >3.5 | 2 mg for 4 days | ||
| 2.8–3.2 | 2 mg | ⩽1.7 | 3 mg |
| 1.8–2.4 | 2.5 mg | ||
| 2.5–3.0 | 2 mg | ||
| 3.1–3.5 | 1.5 mg for 4 days | ||
| >3.5 | 1 mg for 4 days | ||
| 3.3–3.7 | 1 mg | ⩽1.7 | 2 mg |
| 1.8–2.4 | 1.5 mg | ||
| 2.5–3.0 | 1 mg | ||
| 3.1–3.5 | 0.5 mg for 4 days | ||
| >3.5 | omit for 4 days | ||
| >3.7 | 0 mg | <2.0 | 1.5 mg for 4 days |
| 2.0–2.9 | 1 mg for 4 days | ||
| 3.0–3.5 | 0.5 mg for 4 days | ||