Day 1: 5 - 7.5mg oral at bedtime (to ensure absorption on empty stomach)
Day 2 and beyond: 2.5 - 7.5mg daily (usually 5mg)
INR increase of >0.3 - 0.4 per day requires dose reduction
Response also influenced by congestive heart failure, liver disease, Vitamin K deficiency, many drugs
2.5 - 3.5: Mechanical prosthetic valves or recurrent thromboembolism
2.0 - 3.0: All other indications
Warfarin
Clopidogrel
Ticlopidine
Apixaban
Enoxaparin
Ticagrelor
Rivaroxaban
Eptifibatide