How long before surgery should Warfarin be stopped?

Warfarin is an anticoagulant medication that inhibits the synthesis of vitamin K-dependent clotting factors and thus has a significant risk of causing bleeding during surgical procedures. The general recommendation is to stop Warfarin therapy approximately 5 days before elective surgery. This time frame allows for the gradual reduction of its anticoagulant effect and enables the patient's coagulation status to normalize, minimizing the risk of perioperative hemorrhage.

The 5-day interval is particularly important because it takes time for the body to produce sufficient levels of clotting factors to adequately respond to potential bleeding events. In clinical practice, assessing the INR (International Normalized Ratio) is also critical before surgery—typically, it should be within the normal range (around 1.0, depending on the specific procedure).

The other options do not provide sufficient time for the anticoagulation effects to dissipate adequately, which could increase the risk of postoperative complications related to bleeding. Therefore, stopping Warfarin 5 days prior to surgery is the safest and most effective protocol to ensure patient safety during and after the surgical procedure.