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About

Warfarin therapy requires strict monitoring of the International Normalized Ratio (INR) to prevent thrombosis (low INR) or hemorrhage (high INR). This calculator aids clinicians and pharmacists in adjusting the total weekly dose based on current INR relative to the target range (typically 2.0-3.0). It uses standard anticoagulation guidelines to recommend percentage-based dose increases or decreases. The tool also simplifies the complexity of pill management by suggesting how to distribute the new weekly total using common tablet strengths (e.g., 5mg), ensuring patient adherence.

warfarin anticoagulation inr dosing cardiology

Formulas

Dose adjustments are calculated on a weekly total basis:

New Weekly Dose = Current Weekly Dose × (1 ± Adjustment %)

Example: For an INR of 1.4, increasing a 30mg weekly dose by 15%:

30 × 1.15 = 34.5 mg/week

Reference Data

INR ReadingDose AdjustmentAction
< 1.5Increase 10-20%Consider extra dose. Retest in 1 week.
1.5 - 1.9Increase 5-10%Retest in 1-2 weeks.
2.0 - 3.0No ChangeTherapeutic Range. Retest in 4 weeks.
3.1 - 3.9Decrease 5-10%Retest in 1-2 weeks.
4.0 - 4.9Decrease 10-20%Hold 1 dose? Retest in 1 week.
5.0Hold & Seek AdviceUrgent medical review required. Vitamin K may be needed.

Frequently Asked Questions

No. Warfarin management is complex and affected by diet, antibiotics, and liver function. This tool provides a mathematical baseline based on standard protocols.
The calculator assumes a single tablet strength for calculations to keep instructions simple, but the "Weekly Total" can be divided manually if the patient uses mixed strengths (e.g., 1mg and 5mg).
For INR > 5.0, the tool will advise holding the dose and seeking immediate medical attention, as bleeding risk is significant.