Table 2.

Example of dosing nomogram for maintenance of warfarin therapy: Recommended actions to maintain a target INR of 2.0–3.0 and 2.5–3.5.

TARGET INR OF 2.0–3.0	ACTION TO MAINTAIN TARGET INR	TARGET INR OF 2.5–3.5
INR result		INR result
< 1.5	Extra dose, increase weekly dose by 10%–20%	< 2
1.5–1.9	Increase weekly dose by 5%–10%	2–2.4
2–3	No change	2.5–3.5
3.1–3.5	Decrease weekly dose by 5%–10%	3.6–4
3.6–4.9	Hold 1 dose, decrease weekly dose by 10%–20%	4.1–4.9
5–9	Hold 2 doses, decrease weekly dose by 10%–20%	5–9
> 9	Urgent evaluation	> 9

INR—international normalized ratio.

Data from University of Wisconsin-Madison Health.¹⁴