From: The critical interaction between valproate sodium and warfarin: case report and review
 | Premorbidity | Day 1 | Day 2 | Day 3 | Day 4 | Day 5 | Discharge |
---|---|---|---|---|---|---|---|
Warfarin PO | 1.875Â mg QD | 1.875Â mg QD | 1.875Â mg QD | paused | 1.25Â mg QD | 1.875Â mg QD | 1.875Â mg QD |
Diazepam IV | Â | 10Â mg | Â | Â | Â | Â | Â |
LEV PO | 500Â mg QD | 500Â mg BID | 500Â mg BID | 500Â mg BID | 500Â mg BID | 500Â mg BID | 500Â mg BID |
Valproate sodium IV | Â | 1200Â mg Discontinuation at accumulated dose of 2200Â mg | Â | Â | Â | Â | |
Vitamin K1 IV | Â | Â | Â | 5Â mg | Â | Â | Â |
Other medications | isosorbide mononitrate sustained release tablets 40Â mg PO QD, succinate metoprolol tablets 12.5Â mg PO BID | ||||||
INR (time) | Â | 2.02 (10:51) | 2.04 (09:30) | 8.26 (10:56) 5.52 (16:11) 5.32 (22:41) | 2.16 (06:18) | 2.07 (09:34) | 2.43 (10:01) |
PT (seconds) | Â | 22.50 | 22.70 | 86.90 63.00 60.80 | 24.20 | 23.30 | 27.50 |
Creatinine (μmol/l) |  | 75 |  | 126 | 79 | 64 | 58 |
Albumin (g/L) | Â | Â | 38.50 | Â | Â | Â | 31.60 |