I am very careful with Coumadin and patients on the VLCD.  I have them go to the clinic that manages the Coumadin at week one and then per their directions, usually this is every 1-2 weeks.  If there is any concern about stability then we go with the New Direction LCD and still monitor. Christopher Case, MD

This is generally not a problem.  However, since there is a change in dietary intake, it is probably a good idea to get a Protime drawn after the first week on the diet. John Hernried, MD, FACP