INR Is Up & Down

[loretta]

Hi, I do have the adjustment based chart & do refer to it often.
I take coumadin & the past two weeks (I test on Thurs.) I'm low 2.6 on 3/12 so I increased from 4 mg. to 5 that eve.
on 3//17 it was 2.3 & I took 5 mg again instead of the 4mg. today again it was 2.3. so this eve I will take 5 mg.
My question is this chart says to increase 10 to 15 % weekly I know this is stupid but --- Is weekly from March 17th or count from today? My diet has hardly changed & the only greens I had this week is Romlaine salad, cabbage on ST. Pats day broccoli one day last week. I love greens but avoid most of the week.
I always took 4 mg. a day & it would always jump around. When I would have a high # all I needed to take was spinach & it worked. The only other change I see is that I have started taking Omega 3 fish oil. My trigl are sky high. Dr wanted to prescribe I think Lavanza for my triglis. but when I read up on it too many people complain about side effects. Any suggestsions. Loretta

 

[JimL]

Hi Loretta. I also test on Thursdays, and I was down today too, for who knows what reason.
It seems that you normally take 4 mg a day, which is 28 mg a week. A 10-15% increase (or decrease) would be 2.8 mg (rounded up to 3 mg). So if you did the full increase, you would take 4 mg four days of the week, and 5 mg three days of the week, for a total of 31 mg for the week. It sounds like you were trying to take only part of that increase.
You've been on coumadin long enough to figure out how much to take. My INR was 2.4 this morning, but I've been very sensitive to coumadin for the past year, so I'm only upping my dosage by 1 mg to 35 mg per week.

 

[ALCapshaw2]

As Jim said, you probably need to increase your weekly dose by 3 mg and then test in 1 to 2 weeks. 2 weeks might be better, to give the Coumadin time to become fully metabolized and stabilized.

If your normal dose is 4.4.4.4.4.4.4 you may want to go to a weekly schedule of 4.5.4.5.4.5.4

Do you have 1 mg pills in addition to the 4's?
Or do you have 4 and 5 mg pills?
Either way, you can easily make the needed changes
as shown above.

Do you eat something green (with vitamin K) every day?
It has been shown to be easier to stabilize with a regular ingestion of vitamin K than to try and avoid it completely. That way, any day-to-day change will be relatively small as opposed to the large change of going from nothing to something and back again.

'AL Capshaw'

 

[Cooker]

INR= It's Never Right .... I have been "stable" for three years ... now mine is in the yo yo mode ... if I'm betwenn 2 and 5 I'm happy

 

[loretta]

Yes I do have something green just about every day, except for the greens that have high vit. K like kale, spinach. I only eat those 2 when my INR is a high #. I do take a multi vit that has vit K in it but my system is used to that I have been taking the same one for years never miss a day.
I usually take 2 , two mg a day =4. The drs office nurse gave me some samples of
5's & some 1's. When I'm out of the samples (like soon) I will cut the 2mg in half in order to get to 5. I will take 5mg this eve. & test in a few days. Good??

 

[Freddie]

Okay, I may not be the sharpest tool in the shed when it comes to dosage BUT.......
Why are you only eating high enriched foods like your kale and spinach when your INR is high??
This could explain why your on a small roller coaster ride.
If you want to eat your kale and spinach everyday do so - just dose your diet. Don't diet your dose.

 

[Ross]

Okay, I may not be the sharpest tool in the shed when it comes to dosage BUT.......
Why are you only eating high enriched foods like your kale and spinach when your INR is high??
This could explain why your on a small roller coaster ride.
If you want to eat your kale and spinach everyday do so - just dose your dosage. Don't adjust your diet.

If it's not normally something she NORMALLY would eat all the time, it's not a problem, but if it is something she would normally eat a lot of, she should be eating it. Never try to use food to control your INR. I know people in here say we will just eat some extra K somewhere, but in reality, it does very little to your INR. You have to eat a boat load of something to cause a real change.

You need to set a weekly dose, take it for the full week, then test to see where your at. If too low, increase by 5 to 20% depending on how low, if too high, decrease by 5 to 20% depending on how high. Don't be switching your doses every couple days or you'll never stop bouncing.

 

[ALCapshaw2]

Hi, I do have the adjustment based chart & do refer to it often.
I take coumadin & the past two weeks (I test on Thurs.) I'm low 2.6 on 3/12 so I increased from 4 mg. to 5 that eve.
on 3//17 it was 2.3 & I took 5 mg again instead of the 4mg. today again it was 2.3. so this eve I will take 5 mg.
My question is this chart says to increase 10 to 15 % weekly I know this is stupid but --- Is weekly from March 17th or count from today? My diet has hardly changed & the only greens I had this week is Romlaine salad, cabbage on ST. Pats day broccoli one day last week. I love greens but avoid most of the week.
I always took 4 mg. a day & it would always jump around. When I would have a high # all I needed to take was spinach & it worked. The only other change I see is that I have started taking Omega 3 fish oil. My trigl are sky high. Dr wanted to prescribe I think Lavanza for my triglis. but when I read up on it too many people complain about side effects. Any suggestsions. Loretta

The Lowest COST solution is to use only One Pill per day.

An Easy way to use only one pill per day but still have 'adjustability' is to get an Rx for 4 mg and 5 mg.

4 mg X7 days = 28 mg
5 mg X7 days = 35 mg

By alternating appropriately, you can vary your weekly dose anywhere between 28 and 35 mg and still take only one pill per day.

Another simple way to achieve your desired range would be to have Rx for 4 mg and 1 mg, using the 1 mg pills to supplement the 4 mg on days you need to go to 5 etc.

'AL Capshaw'

 

[loretta]

Thank you all, I will start changing a few things, like setting a weekly dose, & eating leafy green veggies not only when my INR is a high #. I just became a border-line
diabetic ( not on meds yet for it) so I am trying to eat better & less starchy veggies.