very sensitive to warfarin

[marciemarine]

I had both my aortic and mitral valves replaced on Nov. 1st with ON-X mechanical valves and at the hospital my doctor commented that I was very sensitive to coumadin. He told me that would mean that I would need a low dose. Now it has been nearly five months and I have been back to work for a few months and am more active than I was before surgery since I don't feel so tired and short of breath. My doctor says my INR should be between 2.0 and 3.0. Anyway, I have been having blood tests every two weeks lately and my dctor has determined that at 1mg. a day, my INR was creeping higher to 3.2, so he is having me take alternating doses of 1mg one day and 1/2mg the next. Last week when I had my blood work done, my doctor said my INR
is creeping up again and he now has be taking 1/2mg every day and retest in 2 weeks. My question is why am I so sensitive to warfarin? This morning I was sitting in a recliner and my nose started to run and when I wiped at is with a tissue, I found it was bleeding. That has happened once before a few weeks back, but I average maybe one nosebleed a year. What's with that?
Don't get me wrong, I am happy to take a very low dose, but I'm wondering why and if I'm just strange.
Marcie

 

[ALCapshaw2]

Hmmm...

For starters, ask your Pharmacist if any of your other medications have an interaction with Coumadin.

Are you avoiding foods which contain vitamin K?

If so, you may find that eating greens everyday may actually help stabilize your INR better than abstenance, as long as you are consistent in your consumption of vitamin K containing foods (mostly veggies).

Note that the Safe Range for INR is from 2.0 to 5.0 so I would NOT be overly concerned about an INR of 3.2

Actually, if you had received any OTHER mechanical valve (i.e. NOT On-X valves), the recommended range for dual Aortic and Mitral (or Mitral alone) is 2.5 to 3.5 and some people are told to use 3.0 to 4.0 if they are prone to clots, TIA's or other clotting issues.

'AL Capshaw'

 

[Persianlady05]

to marsi

to marsi

HI my name is chris my body is senceitve to it also I had my AVR in 2000 and i have been on 3 milgs. every since my INR normal range is 2.0-3.0 I get nose bleeds when its high and i have been hospitzied serveral times when the INR was 100 i had hemotoms and my feet would begin to hurt the tops of them before i would get brusing so i can certainly understand take care

 

[sue943]

Although I am no expert and I am not going to give you advice, I would say that with my two ATS valves my INR has to be between 3 - 4 and I am fine with that. From time to time when blowing my nose I do get some bleeding, but I don't get nose bleeds per se. I am on 5mg each day.

 

[Guest]

The reason that you need such a low dose of warfarin can probably be traced to your choice of parents. Had you chosen some with less efficient variations of the liver enzymes that metabolize warfarin, you would probably be ?normal?.

With the On-X valve you can likely get by with a slightly lower INR range. Your warfarin manager has not grasped the concept that the range has little to do with your well being. There is very little risk of major bleeding from an INR under 5. ?Creeping up to 3,2? is not a cause for adjusting the warfarin dose. It is just mental exercise to adjust a dose at this level. Major bleeding means needing a transfusion or bleeding into the brain. Bloody noses are nuisances (for the most part) not life threatening. Dr. Allan is the expert here, but I?ll guess that you might need a spot cauterized.

You would probably curt your risk of nosebleeds by running a humidifier.