Please help. I have a patient who is currently on riveroxiban and needs to commence on warfarin. They have to stay on riveroxiban untill inr over 2.0 where then they would stop riveroxiban and cont warfarin therapy. What would be the best regime for this and is there any red flags we will have to look out for.

Dear Donna,
Normally warfarin start would be 'slow initiation' at 2mg per week for 2 weeks , checking the INR after 7 days (Oates et al regimen). This would be for AF patients.
If the patient has clotted e.g. DVT or PE you would be best to use a fast induction regimen.
Regards
Colm Rafferty