INR precautions: If INR is between 4.0 and 5.0, what level of exercise is allowed?

• A. No exercise
• B. Moderate exercise
• C. Resistive exercise
• D. Light exercise

Answer: (D)

When on anticoagulation, higher INR means your blood is more prone to bleeding. An INR in the 4.0–5.0 range is above the usual therapeutic level, so the safest approach is to keep activity gentle and low-risk. Light exercise, such as walking, easy cycling, or slow, low-impact movement, provides the benefits of staying active without putting you at high risk for trauma or muscle strains that could lead to bleeding. More intense activities, including moderate exercise or any resistive (strength) training, increase the likelihood and potential severity of bleeding if an injury occurs, so they’re avoided in this range unless your clinician specifically approves them. Monitor for signs of bleeding and follow up with your provider if the INR remains elevated.