Inr Record Sheet

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INr record sheet
Some patients require very refined Warfarin dose patterns. It is important to write down your particular dose instructions
and the date of your next blood test.
Warfarin dosage examples
Some examples of dosage instructions are as follows:
daTe
Mon
Tue
Wed
Thu
Fri
Sat
Sun
NexT app.
INR
dosage Instruction: ‘alternate the dose’ 3mg with 3.5mg
20/01/06
3mg
3.5mg
3mg
3.5mg
3mg
3.5mg
3mg
27/01/06
2.5
dosage Instruction: Monday to Friday take 6mg, Saturday and Sunday take 6.5mg
20/01/06
6mg
6mg
6mg
6mg
6mg
6.5mg
6.5mg
27/01/06
2.5
dosage Instruction: Wednesday and Saturday take 6mg, every other day take 7mg
20/01/06
7mg
7mg
6mg
7mg
7mg
6mg
7mg
27/01/06
2.5
dosage Instruction: Monday to Saturday take 4mg, Sunday take 4.5mg
20/01/06
4mg
4mg
4mg
4mg
4mg
4mg
4.5mg
27/01/06
2.5
dosage Instruction: Monday, Wednesday, Saturday take 1mg, every other day take 1.5mg
20/01/06
1mg
1.5mg
1mg
1.5mg
1.5mg
1mg
1.5mg
27/01/06
2.5
* The dosage is given in milligrams (mg), i.e. the strength of the tablet. please check the strength of the tablet with the strength
written on the bottle.
If you are unsure of your dose program you may also consult your doctor.
dosage record
INR Target Range
NexT
daTe
Mon
Tue
Wed
Thu
Fri
Sat
Sun
INR
appoINTMeNT
Specialist diagnostic Services pty Ltd (aBN 84 007 190 043) t/a QML pathology
pUB/MR/796, version 1 (Feb-10)

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