Therefore, it is recommended that heparin (or LMWH) therapy overlap with warfarin therapy once the therapeutic range is achieved (INR target, 2.5; range, 2.0-3.0) for 2 days. Stroke due to ...

If the patient had an INR of >1.6 on the day before surgery ... If a patient is receiving thromboembolic prophylaxis via subcutaneous heparin, the drug should be discontinued for 12 hours ...