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Warfarin high INR — GPhC CRA MCQ

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ModerateCardiovascular TherapeuticsWarfarin high INRGPhC CRA

A patient on warfarin brings an anticoagulation record showing an INR of 5.8 from today. He has no bleeding and asks whether to collect his usual repeat prescription. What is the most appropriate action?

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Correct answer: A — Withhold warfarin supply pending anticoagulation clinic advice today

An INR of 5.8 is above the usual therapeutic range and increases bleeding risk. Management depends on bleeding, target range and local protocol, so same-day anticoagulation advice is needed before further dosing. Dietary advice is not an adequate response to a markedly high INR. Aspirin would increase bleeding risk and is not a substitute.

Reference: BNF; local anticoagulation guideline