Hello. Thank you for using HCM. I carefully read your concern. Acenocoumarol is an oral anticoagulant, which takes effect on the body after 48-72 hours. Therefore, the opposite is also true - if you discontinue it, you should wait 48-72 hours for the effect to wear off. Now, every time that INR goes off the range, various methods and dosages can be used to maintain it within range, depending on how high or how low it is. In this scenario, I would recommend a more often measurement of the INR, and consulting the doctor for the dosage of acenocoumarol, on a daily basis, untill a more equilibrated dosage can be instituted. I hope I was helpful. Take care.