Management Principles of Subtherapeutic INR

• Patient education regarding 
• Compliance

• Drug/Food interactions with warfarin  

• Effects of low INR 

• When truly genetic resistance 

• Increase the dose of warfarin 

• Titrate the dose carefully to >100 mg/day with regular monitoring of INR 

• Change the anticoagulant 

• UFH, LMWH, Fondaparinux 

• Rivaroxaban, Dabigatran 

• Other Vitamin K antagonists 

• Bishydroxycoumarin

• Phenprocoumon 

• Acenocoumarol

• Phenindione