The challenge with WARF is to control the antagonism of vitamin K, etc. or a deficiency of this vitamin reduces the rate at which these factors and proteins are produced, thereby creating a state of anticoagulation. Prescribing the dose that both avoids strokes, etc. sufficient suppression of clots requires a thorough understanding of the drug's unique pharmacology.
"For most indications, the dose is adjusted to maintain the patient's International Normalized Ratio (INR) at 2 to 3. Because of the delay in prothrombin suppression, WARF is administered concurrently for four to five days to prevent clot propagation".
"Warfarin is the oral anticoagulant most frequently used to control and prevent thromboembolic disorders. Warfarin has a complex dose-response relationship that makes safe and effective use a challenge. Loading doses of warfarin are not warranted and may result in bleeding complications. Interactions with other drugs must be considered, and therapy in elderly patients requires careful management. Current dosing recommendations are reviewed, and practical guidelines for the optimal use of warfarin are provided".
Hope this helps, and if you have any further questions or comments you are welcome to respond. Thanks for your question. Take care.
Ken
I wanted to know why INR Fluctuates
Well you need his doctor to answer for that question.
Best wishes