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Thread: Prednisone and INR...

  1. #1
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    Question Prednisone and INR...

    I have been put on Prednisone for 12 days due to disc issues in my back... I searched through previous threads and saw that it can raise INR, which my nurse told me as well. I just got tested on Wed. and was 2.7. She wanted me to come in tomorrow and not wait till Monday to see if it is going up, but I am wondering if that is too soon? She seemed concerned. But at 2.7 I have room to go up since I'm a mitral. Just wondering if the meds would raise it significantly or slightly, or what others have experienced with being on Prednisone.

    Forgot to mention, I just started the meds yesterday (Thurs.) a.m. - 60 mg for the first few days, then decreasing as I go.

    Thanks!
    Halley
    Mitral Valve Repair 1/9/07
    Mitral Valve Replacement, Carbomedics valve 8/22/07
    http://www.zazzle.com/halleyg/gifts?...26522942144637
    https://www.facebook.com/#!/groups/mineticks/

  2. #2
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    I am very interested in this thread. It looks like they are going to put Brian on prednisone also. Halley, please let me know your experiences with the steroids, I am really scared about it.
    Deanne
    __________________________________________
    Mom of patient - 19 yr old Brian (pictured)
    Aortic dissection, 2 emergency OHS 6/30/06 & 7/1/06, heart failure, implantation of Heartmate II LVAD, triple CABG
    3/13/07 explantation of LVAD, on-x aortic valve, dacron ascending aorta, mitral valve repair, 1 new CABG

  3. #3
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    I'm allergic to the odd plant and a week or so ago I got ahold of a doozy and got a rash on my wrist. So, it's prednisone time...hate the nasty tastin' stuff, but it sure works. Don't know if it affects my INR since I've never been stable in 10 years..

    Goodluck Halley..!!
    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..."

  4. #4
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    60mg, I'd do as she requested. That is a lot of Prednisone. Your body is going to freak out. I was on that dose for 5 years and it destroyed my left hip. Thank God you'll only be on it for a few days.

    Really it is too soon to test tomorrow if you just started it yesterday. It's going to rise and quickly, but I don't think there is any danger in waiting until Monday.

  5. #5
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    Thanks Ross, will wait until Monday then. That's terrible about your hip, I know it's bad if you have to take it for long periods of time. I've only taken it once or twice before OHS but for even a shorter period than I am taking it now.

    Janie, I took it before for some crazy poison ivy that would not go away! It does work well.

    Deanne, will let you know how it goes!
    Halley
    Mitral Valve Repair 1/9/07
    Mitral Valve Replacement, Carbomedics valve 8/22/07
    http://www.zazzle.com/halleyg/gifts?...26522942144637
    https://www.facebook.com/#!/groups/mineticks/

  6. #6
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    There isn't a lot of good information on this interaction, but indications are that it is real and takes about a week (+/- a few days) for the maximum effect on INR to be seen, as the proposed mechanism is a change in metabolism, and it takes time for the levels to rise and stabilize when the metabolic rate is changed, particularly if the metabolic rate is SLOWED, as seems to be the case here.

    http://www.theannals.com/cgi/content...urcetype=HWCIT

    Below is another online version of the same article's introduction that gives some background information. This interaction is real, but it is disappointing how little good information there is, isn't it?. Anyway, get checked.

    http://www.medscape.com/viewarticle/553030

    Bill Ball, Pharm.D.
    BAV dx'd 10/08
    Ao enlargement dx'd 8/09
    SJM 25mm Master Grafted valve, lower aortic arch replacement 10/21/09 by D. Craig Miller, MD at Stanford University Hospital
    I am a VERY happy man.

  7. #7
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    Halley,
    I have been on predizone several times, for as long as four months, up to 80 mg a day then tapering off. I never really noticed a big difference in my INR but everybodys different.
    The last time i was on predizone it cuz'ed my nerveous system to be shakey and i had some mood swings. I will never go on that high of a dose again. It was scary! The stuff works great but the side affects are bad.
    Make sure you ck out the side effects. You are'nt going to be on it that long so you should be ok.
    Good Luck.
    Let us know how you do.
    OHS 6/20/2006

  8. #8
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    Quote Originally Posted by CThrock View Post
    Halley,
    The last time i was on predizone it cuz'ed my nerveous system to be shakey and i had some mood swings. I will never go on that high of a dose again. It was scary! The stuff works great but the side affects are bad.
    Make sure you ck out the side effects. You are'nt going to be on it that long so you should be ok.
    Good Luck.
    Let us know how you do.
    Pffft, mood swings is an understatement. I had a store full of employees ready to shoot my arse. They thought I was the worst manager they've ever seen. I blew up like the Michelin man too. Guess you would have some mood swings if the stuff is eating away at your bones.

  9. #9
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    That sounds awful y'all, I'm not having any mood swings, just having trouble sleeping but it's making me kind of wired so I can get trough my day OK. The worst part is the back pain is keeping me from the gym, but I can go walking and I will be back at yoga class next week. Thankfully I got my one 5K in before this b/c I probably shouldn't run anymore.

    Bill, thanks for the info!
    Halley
    Mitral Valve Repair 1/9/07
    Mitral Valve Replacement, Carbomedics valve 8/22/07
    http://www.zazzle.com/halleyg/gifts?...26522942144637
    https://www.facebook.com/#!/groups/mineticks/

  10. #10
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    Good luck Haley! Corticosteriouds are the proverbial double-edged sword. Powerful, effective, but they come with a price. A short blast of predinisone with a rapidly decreasing dosing schedule over a week or so, is usually well-tolerated, maybe with a little euphoroia/sleeplessness and possibly some effect on INR, although it's not consistent, as CThrock's case shows and probably not marked enough to cause in significant change if the number of days you are on prednisione at high doses is limited.

    Bill Ball, Pharm.D.
    BAV dx'd 10/08
    Ao enlargement dx'd 8/09
    SJM 25mm Master Grafted valve, lower aortic arch replacement 10/21/09 by D. Craig Miller, MD at Stanford University Hospital
    I am a VERY happy man.

  11. #11
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    I was on pred a number of years ago. Can't recall it having a huge impact on my INR. Only med I can ever recall spiking my INR was Monistat. INR was over 8.
    All the best,
    LuvMyBirman :)
    MVR, 3/99

  12. #12
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    Default My prednisone story

    I've been on prednisone now for about two years. I have polymyalgia rheumatica (muscular rheumatism). Lots of pain and weakness. When I couldn't get up out of a chair any more I saw my PCP who found my sed rate and C-reactive protein tests sky high. The next test was to give me 10mgm prednisone /day. If I had miraculous relief of symptoms , this would confirm the diagnosis of PMR. It did. Now after two years my CRP and sed rate are down and I am tapering off-10,9, 8, etc. slowly one mgm a month. I'm taking 9 right now and doing OK. Oh and by the way 10 mgm never affected my INR.
    For me prednisone was truly a wonder drug.
    Marty
    Mitral valve replacement
    September 17, 1998
    Mechanical St. Jude
    Inova Fairfax, Falls Church VA
    Dr. Ed Lefrak

  13. #13
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    I'm wondering now, since I'm in the weaning stage, if I should even bother getting my INR checked tomorrow? No use in making changes if I'll be off of it in a week...?
    Halley
    Mitral Valve Repair 1/9/07
    Mitral Valve Replacement, Carbomedics valve 8/22/07
    http://www.zazzle.com/halleyg/gifts?...26522942144637
    https://www.facebook.com/#!/groups/mineticks/

  14. #14
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    Halley - I just finished a 10 day run of Prednisone for back pain. I, too, was told it would affect my INR. I home test so I checked on the 4th day - no change from my usual 2.8 - 3.0. I tested again on day 9 - again no change, still at 2.9.

    Good luck with your treatment, I hope it helps you feel better.
    [COLOR="Navy"]Faye J[/COLOR]

    [COLOR="Indigo"]Co-Arctation Repair 1963
    AVR and Ascending Aorta Replacement 9-5-07[/COLOR]

    [FONT="Comic Sans MS"][COLOR="Blue"]"Don't wait for a great day, go out and [B]make it[/B] a great day!"[/COLOR][/FONT]

  15. #15
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    Quote Originally Posted by halleyg View Post
    I'm wondering now, since I'm in the weaning stage, if I should even bother getting my INR checked tomorrow? No use in making changes if I'll be off of it in a week...?
    Halley, don't sweat it. Prednisone only causes trouble at high doses over long periods.In my view 60mgm is high so your doctors are right in tapering you down. Get your INR checked a couple a days after you are off of it completely and go from there.
    Marty
    Mitral valve replacement
    September 17, 1998
    Mechanical St. Jude
    Inova Fairfax, Falls Church VA
    Dr. Ed Lefrak

  16. #16
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    Quote Originally Posted by Faye View Post
    Halley - I just finished a 10 day run of Prednisone for back pain. I, too, was told it would affect my INR. I home test so I checked on the 4th day - no change from my usual 2.8 - 3.0. I tested again on day 9 - again no change, still at 2.9.

    Good luck with your treatment, I hope it helps you feel better.
    Faye, what was your daily dose? Did they taper you off of it or go cold turkey?
    Marty
    Mitral valve replacement
    September 17, 1998
    Mechanical St. Jude
    Inova Fairfax, Falls Church VA
    Dr. Ed Lefrak

  17. #17
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    I started with 60 mg of prednisone, about one month after my AVR, when all else failed for my pericarditis. Had to wean a littler faster than the Dr advised in the beginning. At a higher dose that stuff, makes my CRAZY!! Couldn't sleep, was contantly wired and constantly talking. My hands even started shaking one morning!! I really felt like I was loosing it!! It did WONDERS for the pericarditis though!! Only problem, every time I would discontinue the prednisone, the pericarditis would come back! So I still take 5 mg of it daily. My cardio does not have a problem with that low a dose, even if I have to take it for life. I do have a tissue valve though, so I cant' give any info on interaction with the coumadin.

    Also, I used to be a workout freak! In excellent shape. I was in pretty could shape (for an old lady) not too long before my AVR. Well, now I am somewhat restricted, mainly because of back problems! Watch the back Halley, it is just not worth injurying yourself over! Find out which exercises will work for you, WITHOUT putting added strain on you back! I speak from personal experience. Even went to the emergency room a couple of times.

    Believe me, you don't want to go there! Good luck with everything.

  18. #18
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    Hi Kathy,
    Yes, I am experiencing the wired part of it, which explains why I'm up at 4 am! I am so out of whack with my sleep schedule, but the good thing is that is the worst of it. I'm not wired in a bad way or nervous or anything, just have the right amount of energy to keep me going when I'd otherwise be tired. A couple of days when I first started the stuff I was up all night then crashing during the day. The hardest part for me has been staying out of the gym. I haven't taken this much time off in two years (and it's only been a week). But I know I have to take it easy if I want to get better, and I start phys. therapy soon. I've been doing yoga at home and taking walks. It's been hard for me knowing that I have to cut back on some of my workouts. Also I was told I should never, ever take a spinning class, which is something I was just about to start - caught me just in time! I know with the yoga and swimming, walking, etc. I'll still be able to keep active at a pace that will work for me, though.
    Anyhow, thanks to everyone's input and replies, I think I am just going to wait until I'm through with it and get tested.
    Halley
    Mitral Valve Repair 1/9/07
    Mitral Valve Replacement, Carbomedics valve 8/22/07
    http://www.zazzle.com/halleyg/gifts?...26522942144637
    https://www.facebook.com/#!/groups/mineticks/

  19. #19
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    I was on 60 mg for 3 days, 40 mg for 2 days, 20 mg for 2 days, 10 mg for 2 days, and finally 5 mg for 2 days.


    As far as I could tell, the Prednisone did not affect my INR at all.
    [COLOR="Navy"]Faye J[/COLOR]

    [COLOR="Indigo"]Co-Arctation Repair 1963
    AVR and Ascending Aorta Replacement 9-5-07[/COLOR]

    [FONT="Comic Sans MS"][COLOR="Blue"]"Don't wait for a great day, go out and [B]make it[/B] a great day!"[/COLOR][/FONT]

  20. #20
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    I've noticed that steroids do affect my INR. Eight days ago I had an INR of 2.7. Seven days ago my right ankle was injected with steroids. Yesterday my INR was 4.4. It was about what I expected so I didn't change my dose since it will soon settle back into range.
    Betty(bvd)

    Rheumatic Heart Disease
    St.Judes Mitral Valve
    Heart Port procedure
    Dr. D.Glower, surgeon
    Duke University Hosp. 8/25/03

    John 1:5 The light shines in the darkness, and the darkness has not overcome it.

  21. #21
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    Quote Originally Posted by Faye View Post
    I was on 60 mg for 3 days, 40 mg for 2 days, 20 mg for 2 days, 10 mg for 2 days, and finally 5 mg for 2 days.


    As far as I could tell, the Prednisone did not affect my INR at all.
    Faye, This is a good regime for acute pain not for my condition which is chronic. It is safe because of the short duration of the therapy. Did it work?
    Marty
    Mitral valve replacement
    September 17, 1998
    Mechanical St. Jude
    Inova Fairfax, Falls Church VA
    Dr. Ed Lefrak

  22. #22
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    Default And the verdict is...

    I caved and got checked, figured with Thanksgiving coming up I'd test so not to be wondering. Anyhow, 3.4! Perfect. I guess it did raise it, from 2.7 last week, but I actually predicted correctly and it came up just enough. I prefer to be in the 3's.
    Halley
    Mitral Valve Repair 1/9/07
    Mitral Valve Replacement, Carbomedics valve 8/22/07
    http://www.zazzle.com/halleyg/gifts?...26522942144637
    https://www.facebook.com/#!/groups/mineticks/

  23. #23
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    halley, good stuff....3.4 is definitely perfect.
    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"

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