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Thread: My INR today was 4.5!

  1. #1
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    Angry My INR today was 4.5!

    I went in today to have my INR tested it was 4.5, wow! Never been that high before I take 10mg a day she told me to take 5mg tonight and 5mg tomorrow night, she did not want me to skip because she did not want it to come down so quickly. I am suppose to be between 3.0 and 3.5 but I really feel better at about 2.8. I do not do home testing yet but am going to start. What do you suggest I do to get it down? I like to have all the advise I can! Thanks a Million!
    [COLOR="Blue"][/COLOR][COLOR="Red"]"Glad to be alive by God's Grace"![/COLOR]
    [COLOR="blue"][COLOR="red"]"If God brings you to it, He will bring you through it":)[/COLOR][/COLOR]

    [B][COLOR="Red"]Nov 06 Replacement of Aortic Heart Valve St.Jude! Bentall procedure done to repair my 6cm anueuysm St Dominic Hospital Dr Gerhard Mundinger my wonderful Surgeon,& Dr. Clay Hayes Jr. All the Wonderful nurses, surgical team! And of course the Sisters that prayed for me everyday! Along with my 88 year old daddy that made me walk with him everyday! God Bless! each one of you![/COLOR][/B]

  2. #2
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    So your INR is 4.5.....NO big deal at all.....I would take 5 mg (half dose) tonight only and leave it at that.
    It is far better to be a tiny bit higher than to be too low.
    BAV-Aortic Stenosis...AVR Oct 11, 2005 / St.Jude Regent mechanical 21mm
    INR Home testing since 2007 with Coaguchek XS...Self-Dosing

    "Caution: I may have been in contact with Nuts"

  3. #3
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    Quote Originally Posted by terodac View Post
    I went in today to have my INR tested it was 4.5, wow! Never been that high before I take 10mg a day she told me to take 5mg tonight and 5mg tomorrow night, she did not want me to skip because she did not want it to come down so quickly. I am suppose to be between 3.0 and 3.5 but I really feel better at about 2.8. I do not do home testing yet but am going to start. What do you suggest I do to get it down? I like to have all the advise I can! Thanks a Million!
    Nothing to panic about! 4.5 is NOT that high! Your lab tech was correct in telling you to take 1/2 tonight instead of skipping altogether.

    Personally, and I take 10mg daily too & on the 7th day, I take 7.5, when my INR is at this level 4.0 - 4.8, I'll 1/2 for one night & then resume my usual dose the next day but if she wants you to take 1/2 tomorrow also, then do that.

    When does she want to re-test? You might have to start sticking a 7.5 dose in there if the 10mg is putting you over the mark. I too, feel better when I'm on 3.0 or a little less although they say that you cannot feel anything when you are either high or low, but I know I can! And I've been on coumadin for 34 years!

    Hopefully the next time you test, you'll be on the mark.
    Best Regards,
    N Jean

    May/1975: AVR & MVR -- St. Luke's, Houston TX (Denton Cooley, Surgeon)
    Dec/1975: MV Repair -- St. Luke's (Dr. Cooley)
    Mar/2006: AVR -- St. Luke's, Houston TX (George Reul, Surgeon)


    "Nothing in life is to be feared, it is only to be understood. Now is the time to understand more, so that we may fear less."
    - Marie Curie

  4. #4
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    I remembered we were in a panic the first time my husbands INR was over 4.0. I came here to VR and they calmed my fears. He takes 7.5 daily and he took 6.0 for 3 days retested and was at 3.3. Now we no longer panic when its over 4.0 and know what to do.
    Sue(wife of patient-Terry)
    BAV diagnosed-11/00
    ATS Mechanical Valve-9/11/01

  5. #5
    westie Guest

    Default no drama

    .
    i remember testing myself at 4.0 inr 2 days after i left hospital and being pretty worried. these days i sometimes hit 4.5 inr, but that does not worry me too much.

    it is much better to be 4.5 than 1.1 inr!

  6. #6
    Karlynn Guest

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    3.0 - 3.5 is too tight a range. Given that your INR # can have a .3 variability - it doesn't leave much room.

    The directions you were given aren't bad. I take 10/day and probably would just 1/2 it for one day. But I've been on "the stuff" for over 17 years, so I'm pretty in tune with how my body handles dosage adjustments. You'll learn too.

    Why do you feel better at 2.8? Most of us prefer to be at the top of our range, knowing that it's much easier to lower a too high INR than to raise a too low INR.

    (Psssst - I've been a lot higher than 4.5 with no issues. So don't be too worried. )

  7. #7
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    There is always the question of "was this an erroneous measurment".
    MY Coumadin Clinic does a Lab Draw for any INR over 4.5 as a 'double check'.

    Personally, I would take 1/2 Dose for ONE night (not two) and retest in 4 to 7 days. (AL Lodwick recommends waiting 2 weeks to retest which is probably OK... I just like to know a little sooner... NEVER test in less than 4 days after a change in dose... that can lead to a 'roller-coaster' effect)

    I like to 'ease back' into range with Small Changes to avoid the Roller-Coaster Effect. Fortunately, my Coumadin Clinic seems to follow the same philosophy.

    'AL Capshaw'

  8. #8
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    If I am between 2.5 and 5.0 I'm a happy Chimp .... if you try and keep to tight of range you will drive yourself nuts
    No shoes, no shirt, no problem
    AVR with Ablation -St Jude Mechanical--2006
    ~Easy Does It~

    The early bird get the worm but the second mouse gets the cheese

  9. #9
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    She told me it most likely were the antibotics I was on to clear up a sinus infection! I was taking ciprofloxin? and she said it was very strong and would throw my INR way off. I ate a salad yester day and some other green stuff took 5mg last night did not take my baby asprin tonight I will do my 5mg also not baby asprin. I am going back to get it tested again on Monday! So sick of running down there I am going to home testing! 6.5 would have just put me right over the top of a nervous breakdown! Good Luck to you! And thanks for all the good advise! I really appreciate it!
    [COLOR="Blue"][/COLOR][COLOR="Red"]"Glad to be alive by God's Grace"![/COLOR]
    [COLOR="blue"][COLOR="red"]"If God brings you to it, He will bring you through it":)[/COLOR][/COLOR]

    [B][COLOR="Red"]Nov 06 Replacement of Aortic Heart Valve St.Jude! Bentall procedure done to repair my 6cm anueuysm St Dominic Hospital Dr Gerhard Mundinger my wonderful Surgeon,& Dr. Clay Hayes Jr. All the Wonderful nurses, surgical team! And of course the Sisters that prayed for me everyday! Along with my 88 year old daddy that made me walk with him everyday! God Bless! each one of you![/COLOR][/B]

  10. #10
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    Don't overdo your dosage correction....you are freaking out for nothing.
    Two half doses is a large correction, you don't need to binge on greens. Relax......
    BAV-Aortic Stenosis...AVR Oct 11, 2005 / St.Jude Regent mechanical 21mm
    INR Home testing since 2007 with Coaguchek XS...Self-Dosing

    "Caution: I may have been in contact with Nuts"

  11. #11
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    I agree with the above recommendations!! trust them!! When I needed help with my dosage adjustment, I followed our friends' advice here and not the doctor's recommendation....I was fine. I am not an expert yet, but I agree not to overdo the dosage correction.
    Eva

    Aortic & Mitral valves replaced with St. Jude Mechanical valves @ age 57 on 9/2/08

    INR home tester/Coagucheck

    Forum Rules: " .... medical opinions expressed in this forum are the personal opinions of individuals. No person should at any time
    act on the information contained herein without the express consent of your own physician."

  12. #12
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    Ok! Today I went in for a recheck of my 4.5, did what I was told cut my 10mg dose in half on Wed & Thurs. nights, also took it on myself to only take 7.5 on Friday night. Today Monday! it was 1.9?? I just can't believe this drop in five days, I get a recheck next Monday! I did eat a salad and avocado dip and a few green beans during this time, it sure was good. Does anyone understand why it would drop like that? This INR crap is driving me up a wall! Help me, I am sick of it!
    [COLOR="Blue"][/COLOR][COLOR="Red"]"Glad to be alive by God's Grace"![/COLOR]
    [COLOR="blue"][COLOR="red"]"If God brings you to it, He will bring you through it":)[/COLOR][/COLOR]

    [B][COLOR="Red"]Nov 06 Replacement of Aortic Heart Valve St.Jude! Bentall procedure done to repair my 6cm anueuysm St Dominic Hospital Dr Gerhard Mundinger my wonderful Surgeon,& Dr. Clay Hayes Jr. All the Wonderful nurses, surgical team! And of course the Sisters that prayed for me everyday! Along with my 88 year old daddy that made me walk with him everyday! God Bless! each one of you![/COLOR][/B]

  13. #13
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    Default another misery loves company post..

    Hi there terodoc. Same song, second verse.. I tested at 1.8 Sunday morning so I took 14mg Sunday morning and 12 mg this morning. My usual dose is also 10mg. I have no explanation for my drop. I blame it on being Catholic..

    I feel the same as you about this crappy a$$ warfarin stuff. Maybe we need a double pomegranate martini this evening..
    Happy Trails,

    BAV-1999 - St. Jude Silzone recalled valve still clickin'
    CoaguChek testing since 1999
    CoaguChek S testing since 2002
    CoaguChek XS testing since 2009
    "Gee, ain't it funny how time jus' slips away..."

  14. #14
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    Yea she told me to take 15mg tonight lay off green! I would love a Martini! I use to enjoy that also! I think I will start drinking again, he did tell me a could have a few oz of wine a night, I just haven't gone there YET! I feel it is coming soon! LOL! I looked up pomegranate juice the other day and it does not have much vit k in it, was on the low side! Does anyone drink and take warfarin?
    [COLOR="Blue"][/COLOR][COLOR="Red"]"Glad to be alive by God's Grace"![/COLOR]
    [COLOR="blue"][COLOR="red"]"If God brings you to it, He will bring you through it":)[/COLOR][/COLOR]

    [B][COLOR="Red"]Nov 06 Replacement of Aortic Heart Valve St.Jude! Bentall procedure done to repair my 6cm anueuysm St Dominic Hospital Dr Gerhard Mundinger my wonderful Surgeon,& Dr. Clay Hayes Jr. All the Wonderful nurses, surgical team! And of course the Sisters that prayed for me everyday! Along with my 88 year old daddy that made me walk with him everyday! God Bless! each one of you![/COLOR][/B]

  15. #15
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    Well, you can add me to the see-saw too! I tested last night & my INR was 4.5. The week before it had been 3.6 so I made no changes to my dosage taking 10mg for 6 nights & 7.5mg one night.

    So last night when I got 4.5, I took 5mg instead of my usual 10mg & I'm sticking 2 nights of 7.5 & check again next Sunday & see where I am.

    Only thing that has changed was I started taking the revatio again so perhaps that has something to do with. I'm not worried about it however, because since I have a home tester, I can test next week & stay on top of it.

    I'm not sure that I agree with your lab telling you to stay away from the greens because you DO NOT dose the diet. You should be able to eat what you want to eat with consistency of course!

    Good luck & I hope you get back on range.
    Best Regards,
    N Jean

    May/1975: AVR & MVR -- St. Luke's, Houston TX (Denton Cooley, Surgeon)
    Dec/1975: MV Repair -- St. Luke's (Dr. Cooley)
    Mar/2006: AVR -- St. Luke's, Houston TX (George Reul, Surgeon)


    "Nothing in life is to be feared, it is only to be understood. Now is the time to understand more, so that we may fear less."
    - Marie Curie

  16. #16
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    Quote Originally Posted by ShezaGirlie View Post
    Maybe we need a double pomegranate martini this evening..
    How about a double pomegranate frozen margarita? Yum.
    AVR-November 14, 2007
    23mm On-X Prosthetic Heart Valve
    Home Test since Jan 2008, Coagucheck XS
    "Everyone has a best friend during each stage of life-only a precious few have the same one."
    By: Unknown

  17. #17
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    Quote Originally Posted by terodac View Post
    Does anyone drink and take warfarin?
    We usually don't kiss and tell around here, , but alcohol will raise your INR, I like to have a couple glasses of wine on the weekend, as long as I don't go overboard my INR does not go above range.
    AVR-November 14, 2007
    23mm On-X Prosthetic Heart Valve
    Home Test since Jan 2008, Coagucheck XS
    "Everyone has a best friend during each stage of life-only a precious few have the same one."
    By: Unknown

  18. #18
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    Default Is the person who regulates your coumadin trying to kill you?

    Terodoc:

    Welcome to the world of medical professionals who should be doing other work. The person who is relgulating your coumadin is making a big error. Pretty soon you are going to be see sawing up and down.

    You have an aortic valvereplacement. Your range should be 2.0 to 3.0. Your latest INR was 1.9......I said it once today, I'll say it again, she is trying to drive in a thumb tack with a sledge hammer. An INR of 1.9 is acceptable for someone whose range is 2.0 to 3.0. This is not a large difference. I would change nothing....If you are so concerned that you feel you must increase your Coumadin, increase it by 1.0.

    Taking 15.0 is definately going to shoot your INR up to the sky.

    Many of us here have told you exactly what would happen...your INR went down. Now, if you do as directed, I am sure your INR increase considerable and you will be higher than before.

    Remember, you have an aortic valve. Your desired range is lower than those with mitral valve replacement because the blood is faster for the aortic valve. You are just fine now.

    Wish you the very best.

    Blanche

  19. #19
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    Quote Originally Posted by terodac View Post
    Does anyone drink and take warfarin?
    Only when I'm by myself or with somebody..

    Louise is gonna send me her fixin's for a pomegranate margarita...YUM Or better yet, maybe she'll invite us up to one of those infamous bars on 6th Street..

    I abide by my cardio's prescription and have a couple glasses of Shiraz or a nice Cab. every night..! Tonight tho, I need a tad more alcohol content, so it's a couple of martinis..
    Happy Trails,

    BAV-1999 - St. Jude Silzone recalled valve still clickin'
    CoaguChek testing since 1999
    CoaguChek S testing since 2002
    CoaguChek XS testing since 2009
    "Gee, ain't it funny how time jus' slips away..."

  20. #20
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    Quote Originally Posted by ShezaGirlie View Post
    Louise is gonna send me her fixin's for a pomegranate margarita...YUM Or better yet, maybe she'll invite us up to one of those infamous bars on 6th Street..
    We'd have to go to this great Mexican restaurant on North 183 by the Arboretum, that's where I discovered them. Movie then dinner, a great evening!

    6th Street ain't all that special to me, been there once or twice, drinks are way over priced, too many people, and better yet, we can make our own at my house, just have to locate a good recipe on line and Voilą!
    AVR-November 14, 2007
    23mm On-X Prosthetic Heart Valve
    Home Test since Jan 2008, Coagucheck XS
    "Everyone has a best friend during each stage of life-only a precious few have the same one."
    By: Unknown

  21. #21
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    Quote Originally Posted by terodac View Post
    Ok! Today I went in for a recheck of my 4.5, did what I was told cut my 10mg dose in half on Wed & Thurs. nights, also took it on myself to only take 7.5 on Friday night. Today Monday! it was 1.9?? I just can't believe this drop in five days, I get a recheck next Monday! I did eat a salad and avocado dip and a few green beans during this time, it sure was good. Does anyone understand why it would drop like that? This INR crap is driving me up a wall! Help me, I am sick of it!

    Let's see, your Clinic advised you to cut your dose by 50% for 2 Days and YOU decided to drop another 25% on day 3 and you are asking why your INR dropped from 4.5 to 1.9???

    Do you remember what several members suggested (i.e. cut 50% for ONE Day and retest in 4 to 7 days)?

    Maybe it's time for you to send $5 to AL Lodwick to pay for his Dosing Guide (see his website www.warfarinfo.com). Then you will "Be Prepared" for the Next Time your INR is out of range.

    The AAFP (American Association? of Family Practicioneers) also has a Dosing Guide on their website. The link has been posted several times in the AntiCoagulation Forum. If you can't find it, ask Ross. He always seems to come up with it's address.

  22. #22
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    Quote Originally Posted by terodac View Post
    ...... Does anyone drink and take warfarin?
    Normally, I drink once in a blue moon ... yet during the last two weeks I had a marguarita, Mojito, 4 0z of wine twice, and Bailey's irish coffee. I also binged these two weeks on avocados, hummus, garlic, spinach, greens I did not care for before (e.g. Broccoli) etc.

    I can't wait to see what my INR is tomorrow at the cardio's office using Coagucheck XS. Two weeks ago it was 2.4 and he asked me to increase my dose (which is 7 a night) by 2 mgs on Tuesdays and remain on 7 the rest of the week.
    Eva

    Aortic & Mitral valves replaced with St. Jude Mechanical valves @ age 57 on 9/2/08

    INR home tester/Coagucheck

    Forum Rules: " .... medical opinions expressed in this forum are the personal opinions of individuals. No person should at any time
    act on the information contained herein without the express consent of your own physician."

  23. #23
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    Quote Originally Posted by Louise View Post
    We'd have to go to this great Mexican restaurant on North 183 by the Arboretum, that's where I discovered them. Movie then dinner, a great evening!
    Hmmmm, that be the same restaurant the "Bush daughters" got busted?? Chuy's..? Hey, those gals oughta know a good Marg..

    Jus' say when..!
    Happy Trails,

    BAV-1999 - St. Jude Silzone recalled valve still clickin'
    CoaguChek testing since 1999
    CoaguChek S testing since 2002
    CoaguChek XS testing since 2009
    "Gee, ain't it funny how time jus' slips away..."

  24. #24
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    Quote Originally Posted by Eva View Post
    Normally, I drink once in a blue moon ... yet during the last two weeks I had a marguarita, Mojito, 4 0z of wine twice, and Bailey's irish coffee. I also binged these two weeks on avocados, hummus, garlic, spinach, greens I did not care for before (e.g. Broccoli) etc.

    I can't wait to see what my INR is tomorrow at the cardio's office using Coagucheck XS. Two weeks ago it was 2.4 and he asked me to increase my dose (which is 7 a night) by 2 mgs on Tuesdays and remain on 7 the rest of the week.
    Man & here I was feeling guilty for drinking a marguarita or mix drink once a month! In hearing you all talk, I'm a saint!!
    Best Regards,
    N Jean

    May/1975: AVR & MVR -- St. Luke's, Houston TX (Denton Cooley, Surgeon)
    Dec/1975: MV Repair -- St. Luke's (Dr. Cooley)
    Mar/2006: AVR -- St. Luke's, Houston TX (George Reul, Surgeon)


    "Nothing in life is to be feared, it is only to be understood. Now is the time to understand more, so that we may fear less."
    - Marie Curie

  25. #25
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    Quote Originally Posted by njean View Post
    Man & here I was feeling guilty for drinking a marguarita or mix drink once a month! In hearing you all talk, I'm a saint!!

    Yes, dear Norma, you are a saint. I do not know what is going on with me...too many celebrations!

    (Being a saint, go and read the latest joke I added yesterday).
    Eva

    Aortic & Mitral valves replaced with St. Jude Mechanical valves @ age 57 on 9/2/08

    INR home tester/Coagucheck

    Forum Rules: " .... medical opinions expressed in this forum are the personal opinions of individuals. No person should at any time
    act on the information contained herein without the express consent of your own physician."

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