I might have missed two days of warfarin...

Valve Replacement Forums

Help Support Valve Replacement Forums:

This site may earn a commission from merchant affiliate links, including eBay, Amazon, and others.

weissarthur

Member
Joined
Jan 5, 2014
Messages
23
Location
Grand Rapids Michigan, USA
I just looked at my pill box... looks like I "may" have missed two days of warfarin! Little freaked out right now. I didnt fill my pill box like i regularly do because my inr was high 4.2 and the docs wanted me to do a certain regimen then check again on monday... so i only filled my pill box with warfarin till monday thinking they would give me new instructions. Now i noticed that instead of going to the next row, I just finished up sunday and monday on the same row (which didnt have any warfarin!) Busy day so I couldnt get to the lab monday and tuesday... here it is tuesday evening and I just took a 5 mg ( I was taking 7.5 4 days a week and 5 3 days)! Needless to say i'm going to get my blood tested tomorrow. How bad is this?
 
Try not to panic, but without knowing for sure if you have missed two dosages, you'll have to wait and see what the results are tomorrow.
It takes 3 days for warfarin to be in your system so the dosage you took tonight won't be fully in your system until Friday. You are probably protected enough for now and your INR result will be on the low end.

What is your INR range? And did your doctor really wanted you to skip two dosages at 4.2? yikes.
 
Hi

weissarthur;n847216 said:
I just looked at my pill box... looks like I "may" have missed two days of warfarin!

bummer ... well it happens ...

Little freaked out right now.

don't get too anxious ... its not really harmful. I would say just take some of your dose as soon as possible (like right then) and resume your normal dose at your normal time as normal

I set an alarm on my phone (which goes off daily) at a time when I know I'll be around my pills (pick one that suits you)


... regularly do because my inr was high 4.2 and the docs wanted me to do

well I guess that that experiment is going out the window ;-)

How bad is this?

its not bad. Your body clears warfarin relatively slowly, so you'll still have a residual. I'd say your INR will probably drop to 1.7 or something like that. Personally I'd not fret about that as a "thing which has happened".


Busy day so I couldnt get to the lab monday and tuesday..

isn't home testing seeming more appealing yet?

Anyway, back to your INR, try reading this tread, it should make it clearer that you're OK

http://www.valvereplacement.org/foru...ps-missed-dose
 
Thanks everyone. I cant begin to tell you what a comfort this forum has been. I only have a few posts, but all of them were so something that weighed heavy on my mind and this community helped me work through them.

Point of clarity, the docs didnt tell me to skip... i skipped on accident. my fault:( I really like the alarm idea! and I looked into home testing, some of my research from a year ago (some of it from this forum) held the general opinion that home testing wasn't accurate enough or reliable enough to trust yet.... has the general consensus on that change?
 
weissarthur;n847249 said:
.......... held the general opinion that home testing wasn't accurate enough or reliable enough to trust yet.... has the general consensus on that change?

I have home tested weekly for about two years while going to my doc for a monthly test. My results and docs results have mirrowed each other and he now trusts my home testing enough to no longer require me to come to his office monthly. I have also found that the weekly testing usually allows me to maintain my INR range using small adjustments to diet.....seldom to I make a Warfarin dosing adjustment.
 
Hi

weissarthur;n847249 said:
held the general opinion that home testing wasn't accurate enough or reliable enough to trust yet.... has the general consensus on that change?

I think that the community is swinging around to accepting it. From Max Plank (think Planks Constant in Physics)
A new scientific truth does not triumph by convincing its opponents and making them see the light, but rather because its opponents eventually die, and a new generation grows up that is familiar with it.

Many Labs now use an i-Stat machine which actually uses exactly the same chemical process as my Coaguchek.

I'm certain that my phone has more CPU and memory than something like this:
2423PH2025_overlay.jpg


http://www.australianprescriber.com/magazine/33/1/6/9

http://www.bloodmed.com/contentimage/reviewarticles/2108.pdf

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2924123/
 
Even if your INR was below 2 for a while, it shouldn't be a big deal -- it's when it's down for four days (or often a week or more) that the risk of stroke has been documented. I'm with the others -- take your daily dose (which you've already done) and continue dosing as usual. Even if you've somehow doubled your dose on one day, it shouldn't be a big deal.

I may be one of the people who gave you the idea that meters are inaccurate. I've been self-testing for more than five years. I started wtth ProTime and moved to ProTime3. From there, it was usually InRatio. I was testing with an InRatio when I had a TIA (which some alarmist doctors called a stroke). When I went into the hospital with symptoms, the InRatio said 2.6 -- the hospital lab said 1.7.

After this, I wanted to find the most accurate method, with the understanding that I'd rather have a meter that slightly understimates the lab results than one that is higher than the actual lab results, because I don't EVER want my INR to drop below 2.0 again.

I'm trusting the hospital lab, where I get tested monthly.

In my experience comparing meters to each other, and to the monthly lab tests, the Coag-Sense is usually .2 - .4 lower the lab, and the CoaguChek XS is usually .2-.5 above the lab. Occasionally one or the other will be even closer to the lab results than this. I no longer trust the InRatio, and it appears (for a while, at least, until they clear up some strip quality issues), to not be a significant rival to the other two meters.

The key here is 'reliability.' I'm using this as a statistical term -- a meter that has a consistent degree of variation from your lab's result should be fine for testing -- in the case of Coag-Sense, I can assume a .2-.4 difference, and the CoaguChek XS will have a similar difference. If they're ALWAYS different by roughly the same amount, such a meter should be perfectly acceptable (and reliable) -- to get the lab value, just add to or subtract from your meter's result.

I am a strong believer in, and proponent of, self-testing. I still think that weekly testing is the best frequency (although I've sometimes gone up to two weeks). In my case, and that of many others, we not only self-test, we also self-manage, while letting the medical professionals think that they're helping. (A monthly blood draw, for comparison with your meter's resultis) is also a good idea.
 
Back
Top