When Should You Restart Warfarin

Restarting warfarin and postoperative bridging – We resume warfarin 12 to 24 hours after surgery, typically the evening of the day of surgery or the evening of the day after surgery, assuming there were no unexpected surgical issues that would increase bleeding risk and the patient is taking adequate oral fluids [8].

When should I restart my warfarin INR?

Clinicians typically restart warfarin at the patient’s prior maintenance dose,6,7 although in a previous study, we found that it took a median of 20.5 days at the prior maintenance dose to reach a therapeutic INR8; prolonged LMWH therapy is needed during this time.

When do you need to bridge warfarin?

After warfarin is stopped, 5 to 6 days before surgery (to allow sufficient time for its anticoagulant effect to wane), bridging anticoagulation is started 3 days before surgery, with the last dose given 24 hours before surgery.