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Dr Basu
Dr Basu, Experienced Specialist
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Experience:  MD
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I need to check the correct protocol -op withdrawl

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Hi - I need to check the correct protocol for pre-op withdrawl of warfarin and replacement with Heparin injections. Should there be a 'clear day' after stopping warfarin and before starting heparin injections. Surgery is day 0, injections are on day -3, -2, -1. Should warfarin stop on day -5 or day -4?
Hi there,That is good question.First you should check the INR.If INR 2-3, then you should stop warfarin on day 4.If the INR is higher than 3 then you stop warfarin on day 5.This protocol works well.Let me know if you need any clarifications.
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