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Lets say we went to 7.5 mg for our normal patient, and on day 5 of therapy, the INR all of a sudden increases by 0.7 from the day before

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In contrast, another trial in 409 women with breast cancer found that ALCAR (3 g/day for 24 weeks) increased anticancer drug (taxanes)-induced peripheral neuropathy and decreased measures of functional status compared to placebo (91)

These include people with inherited metabolic disorders, severe malnutrition, kidney disease requiring dialysis, liver disease, or gastrointestinal conditions that reduce nutrient absorption