INR Management for Pulmonary Embolism

Warfarin Therapy Guidelines

Initial warfarin dosing should be 5-10 mg daily for the first 2 days, followed by dose adjustments to maintain the target INR. 1, 2
Heparin (unfractionated or low molecular weight) should be continued for at least 5 days after starting warfarin and until the INR has been in the therapeutic range (2.0-3.0) for at least 24-48 hours. 1, 2
For patients with pulmonary embolism, the INR should be maintained between 2.0 and 3.0 (target 2.5) throughout the treatment period. 1, 2

Initial INR monitoring should be performed every 1-2 days until stable in the therapeutic range. 1, 2
Once stable, INR monitoring can be less frequent but should be regular to ensure maintenance within the therapeutic range. 1, 2

Inadequate initial anticoagulation: Ensure heparin is continued until the INR is therapeutic for at least 24-48 hours. 1, 2