Testing Frequency

[bonners]

Bina - Started using the Coaguchek last week. Starting to get the hang of it. Question - when do you test? ie in the morning before a meal? After a meal?
Also, when do you take Warfarin? AM, PM?

Thank You, Greg

 

[catwoman]

Your thread said Frequency, but I think you're wanting to know how...

(I posted this elsewhere. Am copying it here.)

I know Bina will be along to answer this.
However, the mfr of INR tester doesn't matter. After nearly 7 years of home-testing and almost that long in adjusting my dosages, I don't think it matters all that much when you test. Because warfarin is a slow-loading dose, it doesn't appear to matter tremendously if you test at night, noon or morning. Or before or after a meal.

I have an INRatio. I usually test in the morning, after I shower and before dressing, but sometimes it's just whenever. I don't test BEFORE showering, mainly because I want that Grand Canyon puncture point to seal. Even with a bandage on it, I don't like putting my hand around hot water for at least an hour or two afterwards.
Some people who adjust their own dosages like to test before taking their meds, so they can make an immediate adjustment if needed.

For those who call in their results, best to test first thing in the morning, then call the results in when your doctor's office opens. If an adjustment is needed, hopefully you'll get a callback by dinnertime. Which for some reason, seems to be "the" time to take warfarin -- for whatever reason. Seems that marching orders upon discharge frequently dictate taking warfarin at night. It's not important what time of the day you take it -- as long as you take it every day at a regular time. I take mine @ breakfast.

As far as how often to test -- that's up to you & your doctor. People who are fairly new to warfarin may need to test weekly until their results are stable. I tested this week, first in 3 weeks, and both previous result and latest result were in range. If you test weekly, you know more quickly if you're heading up or down. If, when I retest I get a result just a nudge over 3.5, I'd retest in a week and just monitor any upward trend. If it gets over, say, 4.2, I'd be making adjustments. I like my INR to be at the higher end of my range (2.5-3.5), even up to 4.0.

In time, all of this will be second nature to you. You won't even think about it. You could almost do your INR tests while sleepwalking. But please don't. You could drop your new toy!

Bina -- what you think??

 

[Protimenow]

There's another thread about this same topic, and I gave a lengthier response there.

Please don't confuse the INR testing with blood glucose monitoring. Aside from getting blood from a finger and applying it to a strip, they're two entirely different processes.

Testing your INR shouldn't change regardless of how close or far from a meal it's done. Although your diet can effect your INR (a lot of green, leafy vegetables filled with Vitamin K may lower your INR), these effects on your testing aren't at all related to how close to, or far from, a meal you are, and I don't think time of day really matters, either. Warfarin (coumadin) is slow acting - it takes days to see the effects of a dose, and the effects diminish rather slowly.

What may be most important is test frequency. If you're a diabetic and try to do the INR testing the same way, you're testing WAY too much, and will run through a supply of strips in days. Once your INR and diet are consistent, you may not have to test more than once or twice a month. Other threads have addressed this quite a bit, and a quick search should find the test frequencies of others on this forum.

As far as when to take your coumadin (if you even asked this), it's best to try and take it about the same time each day (if you take a daily dose). That way, the dose of coumadin flowing through your system is pretty much the same, hour to hour, day to day.

 

[dick0236]

I take my warfarin in the AM when I brush my teeth. I test before noon, normally every two weeks. It really doesn't matter when you take the med or test, but I try to be consistent. For me, the important thing is to develop a routine...and stick too it.

 

[Bina]

Hi Greg and welcome !
Each of us seems to find our own routine and testing frequency will vary.
Since I have a steady INR and am in range I test every 2 weeks, during a quiet afternoon.
Coumadin should be taken regularly....I prefer to take it with my dinner at 6:30 pm
Using a 7-day pillbox helps me to remember if I have taken it or not, if I somehow forget to take it at dinner, then I notice it later when I take my nightly BP med. See what works for you and stick with it.

 

[njean]

I take my coumadin in the evening w/my evening batch of pills. They all go down the hatch together....that way I can never forget taking it.

I also have two 7-day pill boxes....one for my morning batch of meds & one for the evening. I test my INR weekly w/my home monitor because I call my results to Alere & then they transfer my call to my doctor if it is outside of range. I've been quite stable the last few weeks....I try to stay between 2.5 - 3.5 & even a tad higher, but not over 4.0 if I can help it.

I may add, that when you take it is a matter of preference.....whatever is easier for you to remember. The thing to try NOT to do is forgetting to take it!

 

[Philip B]

Testing

Testing

I test weekly. Thursday is my test day. Since changes in INR typically take at least a couple of days, I figure the time I test on Thursday really doesn't matter much. If I manage to engage in a lot of exercise during the course of a week or notice a major shift in my INR, I test more frequently.

-Philip

 

[ShezaGirlie]

I started out taking mine in the evening, but changed to mornings since it's easier for me to remember. Lots of times plans would change in the evening and we wouldn't be home until much later and that didn't seem to work for me. My INR bounced around loads until I changed from evenings to mornings. I test weekly, but only because I'm in the Medicare monitoring scheme. Before that I tested almost monthly and was seldom in range. You'll read on here that 'consistency' is the key and that's correct..!!

Where in the world is Bonners Ferry, Idaho.......?:biggrin2:

 

[olefin]

I've always taken warfarin around 4 pm for when I tested monthly at docs office I usually got the lab results in the morning or early pm. If I was out of control he required weekly testing or sooner until in control.

I started weekly testing as soon as I got on home testing, usually test in afternoon.

In over 19 years, never missed a dose, unless on purpose............................ thanks to wife! :thumbup:

 

[skrob49]

seems more reasonable to take warfarin in the evening and test in the morning. Then, we can call our doc immediately if INR out of range and make adjustments in the same evening. It seems they have these complicated dosing charts. I wonder if the health care providers ever refer to them anyway??

 

[Freddie]

seems more reasonable to take warfarin in the evening and test in the morning. Then, we can call our doc immediately if INR out of range and make adjustments in the same evening. It seems they have these complicated dosing charts. I wonder if the health care providers ever refer to them anyway??

You must remember that the dosage your wife takes in the evening will not show any effect the following morning test results - it takes 3 to 4 days to fully get into ones system - hence the reason for testing once a week after a dosage change. But your right in regards of calling in the results.

I have a feeling that my health care provider uses this: http://www.pace-med-apps.com/CoumCalc.htm (you may want to book mark this site)

 

[Cris N]

I test once a week in the evening when I get home from work. I take my warfarin just before dinner. Any adjustments needed are then reflected in that night's dosage.

Don't forget about the on-line calculator (Sticky) in the Anti-Coagulation section.