Management of an elevated INR in patients taking warfarin

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Management of an elevated INR in patients taking warfarin Management of an elevated INR in patients taking warfarin. Dose reductions should be made by determining the weekly warfarin dose and reducing the weekly dose by 10% to 25% based on the degree of INR elevation. Conditions that increase the risk of thromboembolic complications include history of hypercoagulability disorders (e.g., protein C or S deficiency, presence of antiphospholipid antibodies, antithrombin deficiency, or activated protein C resistance), arterial or venous thrombosis within the previous month, thromboembolism associated with malignancy, mechanical mitral valve in conjunction with atrial fibrillation, previous stroke, poor ventricular function, or coexisting mechanical aortic valve. (INR, international normalized ratio.) (From Witt DM, Nutescu EA, Haines S. Venous thromboembolism. In: DiPiro JT, Talbert RL, Yee GC, et al., eds. Pharmacotherapy: A Pathophysiologic Approach, 8th ed. New York, NY: McGraw-Hill, 2011:333.) Source: Venous Thromboembolism, Pharmacotherapy Principles & Practice, 3e Citation: Chisholm-Burns MA, Wells BG, Schwinghammer TL, Malone PM, Kolesar JM, DiPiro JT. Pharmacotherapy Principles & Practice, 3e; 2013 Available at: https://ppp.mhmedical.com/DownloadImage.aspx?image=/data/books/1450/chi_ch10_f010.png&sec=81144861&BookID=1450&ChapterSecID=81144649&imagename= Accessed: November 07, 2017 Copyright © 2017 McGraw-Hill Education. All rights reserved