Patients may be started on warfarin without using heparin unless cardioversion is to be performed, in which case, ... The recommended target INR is 2.5 with a range of 2.0-3.0.

By day 29, the INR was 4.9 and her platelets were 203,000/mm 3. She was discharged home on warfarin 2.5 mg p.o. daily with a follow-up appointment scheduled for four days later.