Warfarin initiation nomogram (5 mg)
Day 3 to 6 doses by INR after starting warfarin 5 mg on days 1 and 2.
Inputs
0 of 2Therapy day
When to use
- Starting warfarin with parenteral anticoagulant overlap (typical VTE treatment).
Pearls and pitfalls
- Start lower (2.5 mg or less) in older, frail, or malnourished patients, liver disease, heart failure, or interacting drugs.
- Continue the parenteral anticoagulant at least 5 days and until INR is 2 or more for 24 hours.
- A 10 mg start is an option for healthy outpatients (ACCP).
Why use
The published day-by-day table, so doses are consistent across the team.
Days 1–2: 5 mg; days 3–6: dose from the INR band for that day