On-X Aortic Heart Valves: Safer with Less Warfarin On-X Aortic Heart Valves: Safer with Less Warfarin


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5.3 Inr

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  • 5.3 Inr

    I'm debating what to do. My INR was 5.3 today. A week ago it was 3.4. I'm currently taking 76 mg a week and have been since 5/4/05. Prior to that I was taking 70 a week and it was always hovering around the 2.5 to 2.7 range for about 2 months. So from 5/4 to 5/16 I was on 76 and it was 3.4 after 12 days on that dose. Now, a week later, still on the same dose, it's 5.3.

    I'm thinking of skipping a day and then going to 70 again and see what happens. I bumped it because I'd rather be around 3.5 - but certainly not sailing over it like I am now. :o

    Any other ideas?

  • #2
    As you know diet, exercise and phases of the moon affect the INR. 5.3 is better than 2.3. Rather than skip a day, just shift back to 70 and see how you do. You might wind up on something like 73 or so. Maybe adding another 1/2 mile to your walking would burn some of the coumadin off and get the INR down a bit. Again, a bit high is better that a bit low, especially if you've had no real problems with bleeds over the years.
    St. Judes mitral valve April 8, 2005
    Takes a lickin' and keeps on tickin'


    • #3
      Been there, done that back in February (up to 5.5). I had been alternating 6.5 & 7.0 to keep my INR close to 4.0-4.2. I got bronchitis & a fever and my INR was 5.1 on 2/27. I cut my dose to 3.0 the next day (Monday). On Tuesday 3/1 my INR was 5.5 and my PCP had advised me if it got higher than 5.1 to skip a dose, so I skipped my dose 3/1. On 3/2, I took 6.5 and 6.0 the rest of the week. Retested 3/8 and I was at 3.1.
      I thought, fine. So I bumped it back to 6.5, and I was at 5.0 on 3/15. I juggled it a little the next few days and was 3.6 on 3/20. Stayed at 6.0 and was 3.8 on 3/30.
      Stayed at 6.0mg for the next 3 weeks and tested 3.5, 3.4. However, I started running intermittent fevers and was 2.9 on 4/23 and 2.8 on 4/26, 2.7 on 5/5. I bumped my dosage back to 6.5 and have been 3.3-3.5 since.

      Thank heavens I have my own PT/INR machine!!!!!!!!!!!!!!!!!!!!!!!!!!! I'm not sure I would hold a dose if I was 5.5 again -- probably halve the dose and reduce following doses by 10% and retest in a week.
      Marsha (7-28-50), MVP 1990/MVR (St. Jude) & ASD repair 6/24/03 Baylor University Medical Center, Dallas Texas. Hometesting since 11/03, first with ProTime 3, now with INRatio.
      John (3-13-46), MV repair 5/10/07, Dallas Presbyterian, port-access incision, Dr. William Ryan. Chordae ruptured 12/05 in car crash.


      • #4
        Marsha and Jeff,
        Sinced posting I've been rethinking the holding of a dose too. I think I will halve it tonight, I'm afraid I'll start bounding around all over the place if I hold one. I'm going to have a lovely dark green salad for lunch.

        My INR has never been really stable. Just my way of making life interesting!

        Thank God for home testing.


        • #5
          At least you have the trusty Nosebleed QR Trial Size.

          Halving the dose rather than holding sounds good to me too.


          • #6
            If holding a dose were the way to go, the dose to hold would be the one three days ago, not the one today. Just comments from the peanut gallery...
            Imlay City, Michigan
            AVR 11-9-01, St. Jude valve
            DOB 5-18-55


            • #7
              Since your change in dose was so mild I would look into other influences to your INR. Did you check - change in physical activity? dieting? are you taking any multi vitamins or suplements that contain vit K? alcohol consumption?

              Anyway, you can at least go wild with your salads for a few days, so enjoy!

              By the way, a story -
              A doctor told me he saw a patient in ER who was bleeding spontaniously. It so happened the poor woman was on coumadine, dieting for 2 weeks, did not change her dose and hit INR 17!


              • #8
                Anything that changes your intake of vitamin K is dangerous when on warfarin.


                • #9
                  Amen to that, Al

                  I have had to check every week..due to mine being 4.0....Life has changed so much..running down to help daughter with new Grandkids, ect..Dawned on me..Too tired to eat right.....Now, bought some juice with lots of Vit K..for a breakfast drink.....Good news, I have loss 6 pounds. :D I am not changing my dose......Bonnie

                  Bonnie Anderson
                  Date of Surgery..3-25-02
                  (Aneurysm) AVR 23 mm St, Jude Valve
                  Never stand afar and view with fear and trembling that which lies in your way. Face it boldly and see how very small it is, after all.------------------------------------------------


                  • #10
                    Karlynn- I bet you haven't been doing enough guitar pickin. I had a good night on the front porch a couple of nights ago and my INR dropped from 5.1 to 2.1. Just goes to show ya what bleedin from the tips of your left hand fingers can do :D :D Chria