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Warfarin high INR counselling — GPhC CRA MCQ

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ModerateCardiovascular TherapeuticsWarfarin high INR counsellingGPhC CRA

A patient taking warfarin for a mechanical heart valve brings an anticoagulation card showing an INR of 6.1 today. He has no bleeding and says the clinic has not yet contacted him. He asks whether to collect his usual warfarin dose. What monitoring is required?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — Withhold warfarin and contact the anticoagulation service urgently

An INR above the therapeutic range increases bleeding risk and requires urgent management in line with local anticoagulation guidance. Warfarin should usually be withheld pending specialist advice, with escalation if bleeding occurs. Aspirin and dose escalation would increase harm.

Reference: BNF