Flu shot affect INR?

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D

denobobeno

Hey everyone,
Can a flu shot make your INR become unstable? I had my INR checked on Thursday and it was a perfect 3.5..just where my Cardiologist wants me due to my stroke after OHS July 25th.
We didn't change my Coumdin much at all but, on Monday I had dropped down to 1.3. (they double checked on two different machines)
This is unsettling since my stroke occured when my INR was .7... I can't think of anything I did different over the weekend except a flu shot. I did also start some Cipro on Sat. due to a bladder infection.
Any thoughts?
Thanks,
Deana
 
Cipro will increase the INR. I found a study from 1991-1992 where the fluc vaccine did not chamge the INR.another study also from New Zealand indicstr]es that the vaccine in 2000 also caused warfarin interaction in that because of changes in liver enzymes the drug was not metabilozied and remained in the circulation longer. One would expect this to cause an inv]creae in the INR, but whether the retained drug is able to work at the same rate was not discussed and probably not able to be evaluated. Al lodwick has a post on his site entitled ?INFLUENZA VIRUS VACCINE INTERACTIONS WITH WARFARIN? that discusses this.

Regardless, you have changed and need drug dosage changes and close monitoring.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
 
Had my flu shot on Thursday. My INR on Monday was 3.0. I had been 2.9 the week before.
 
My INR has decreased on Cipro. Most antibiotics have that type of impact on my INR. Not much change in my INR's with the flu shot.
 
Not to get off tract here but does everyone with a new valve (mech or tissue) have to get flu shots? I am 55 and never had one before, is this something I should do because of my new implanted friend?
 
In the UK heart patients are generally eligible for a free flu jab. Whether the offer is taken up is a matter of personal choice. I had both flu and pneumonia jabs (one in each arm) a week or so ago and noticed no difference to my INR.
 
Since my husbands valve replacement he gets the flu shot every year and pneumonia shot every 5 years per his doctors recommendations. I have diabetes and also get the flu shot every year. I got mine yesterday and was sick with flu-like symptons all last night. I feel fine this morning. This is the first time I ever had a reaction.
 
RandyL said:
Not to get off tract here but does everyone with a new valve (mech or tissue) have to get flu shots? I am 55 and never had one before, is this something I should do because of my new implanted friend?
Click to expand...
Randy no one HAS TO do anything. Given that the flu could possibly kill you or cause other problems for your heart, it's a wise idea to get one and try to prevent it, but it's not required.
 
RandyL said:
Not to get off tract here but does everyone with a new valve (mech or tissue) have to get flu shots? I am 55 and never had one before, is this something I should do because of my new implanted friend?
Click to expand...

Randy:
Influenza -- a viral infection, which has to run its course -- can lead to secondary bacterial infections (upper respiratory, sinus, etc.). Those infections could be nasty at best, life-threatening at worst. Bacteria could even cause cardiac complications.

The risk of secondary infections is why I have a flu shot each year.

I got my flu shot a couple of weeks ago at the community college where my husband works. The RN who gave the shots told us her grandmother died @ age 24-25 from the flu, along with her 7-month-old baby. (The RN looked to be in her 50s.) This nurse campaigns to get as many college students, employees & their family members to get a flu shot each year.
 
Found out the Red Cross is giving them at a Grocery Store not 10 minutes from me between 10-2 today Only $25. I will get one today.

Thanks Ross and Marsha
 
Just got my shot an hour ago, I will check my INR in a day or 2 and let you know if there is any changes.
 
My wife got the flu shot a couple of weeks ago.
We have not noticed any significant change in her INR.

Deana,
I rememer reading about your stroke.
That was when I came to VR.com for the first time.
My wife's cardio office's GROSS coumadin mismangement dropped her INR to 1.3
I was doing the web search to figure out what to do and it lead me to VR.com
Thanks to your sharing your experience and other members, my wife made it through and is doing fine. We hope your INR gets back up soon!
 
Thanks to everyone for responding to my thread. Once again you were all helpful.
I NEVER miss my Coumadin. I'm paranoid about that...I was told that Cipro would only enhance the Coumadin. I don't know if it made my INR drop or what happened. :confused:
I had a recheck yesterday and I'm only up to 1.6. I called my Cardiologist on Monday when it was only 1.3 and was told I could still exercise just not to do too much. What do you all think about that?
I try not to be overly cautious and be too paranoid about another stroke, but, I guess I just trust your opinion more than any Doctor, since you have all lived it.
I'm just now really getting a consistency with my exercise routine.
Any thoughts are highly appreciated!! :)
xxooDeana
 
denobobeno said:
Thanks to everyone for responding to my thread. Once again you were all helpful.
I NEVER miss my Coumadin. I'm paranoid about that...I was told that Cipro would only enhance the Coumadin. I don't know if it made my INR drop or what happened. :confused:
I had a recheck yesterday and I'm only up to 1.6. I called my Cardiologist on Monday when it was only 1.3 and was told I could still exercise just not to do too much. What do you all think about that?
I try not to be overly cautious and be too paranoid about another stroke, but, I guess I just trust your opinion more than any Doctor, since you have all lived it.
I'm just now really getting a consistency with my exercise routine.
Any thoughts are highly appreciated!! :)
xxooDeana
Click to expand...
Are they doing anything to raise your INR, like increase your dosage? How about putting you on Lovenox until your INR is in range. I wouldn't excercise at all until I'm well back in range as increased excercise is going to cause the INR to drop further. You've already had on stroke, they don't need to be leaving you at risk like this.
 
I would at least up your dose 10% and stop any exercising till you get your INR under control. 1.3 is almost like not taking any at all and 1.6 isn't much better.under 2 is not good with your history.
 
Ross said:
Are they doing anything to raise your INR, like increase your dosage? How about putting you on Lovenox until your INR is in range. I wouldn't excercise at all until I'm well back in range as increased excercise is going to cause the INR to drop further. You've already had on stroke, they don't need to be leaving you at risk like this.
Click to expand...

Ross ( I was hoping you'd speak up)
They raised it from 8,6,6,8,6 to 8,6,8,6,8 until I get checked on Tuesday. I didn't feel like this was enough and told him so...but, he said he didn't want to raise me too much. I am doing my own thing and I took 8 Thurs. and I am not sure how much I should take tonight. I know it's going to be more than 6!
I'm just going on my past experience with my INR and I just didn't think what they told me was enough. I exercised today but, I won't do anything else until I know my INR is in check.
If I should raise it at least 10% (thanks Randy) then I guess I should take 10 Friday and Sat night then go to 6 Sun and Monday and then test on Tues. Would that be a good plan?
I wish I could find someone that knew more about managing my Coumadin! :eek: Can I manage my own?
Thanks again,
Deana
 
denobobeno said:
They raised it from 8,6,6,8,6 to 8,6,8,6,8 until I get checked on Tuesday. I didn't feel like this was enough and told him so...but, he said he didn't want to raise me too much.
Click to expand...

"don't want to raise it too much..." We heard that too ofen before, especially when my wife's INR was below 2.:mad:

http://www.aafp.org/afp/990201ap/635.html

Here is the chart we used that worked well (the chart is about a halfway down). aafp has more recent chart, but I like this old one better. Think the old one is less conservative in raising INR than the new one.
I also ordered Al's chart and we use both.

Since your range is between 3 and 4, you probalby would want to go with the upper range of the suggested % change when you need to raise INR (it has charts for target range of 2-3 and 2.3-3.5 only).
When INR is low, we go with upper number, when INR is high, we go with lower number of the suggested change range (better to be high than low).

Your doc's order seems to low considering your history and current situation.
Even with an aggressive increase, it took my wife more than a week to bring up to the range from 1.3. We found it takes much longer to raise than lower INR. Another reason we go with bigger dosage change when it is low than high.

Hopefully long time members with the same targer range will give you good suggestions, too.

We began self managing only 2 months after the surgery. We were scared at first but we got fed up with irresponsible and ignorant medical people.
Home testing and testing often (not necessarily changing dosage as often as we test) also helped. And keeping a good record.

EJ
 
denobobeno said:
Ross ( I was hoping you'd speak up)
They raised it from 8,6,6,8,6 to 8,6,8,6,8 until I get checked on Tuesday. I didn't feel like this was enough and told him so...but, he said he didn't want to raise me too much. I am doing my own thing and I took 8 Thurs. and I am not sure how much I should take tonight. I know it's going to be more than 6!
I'm just going on my past experience with my INR and I just didn't think what they told me was enough. I exercised today but, I won't do anything else until I know my INR is in check.
If I should raise it at least 10% (thanks Randy) then I guess I should take 10 Friday and Sat night then go to 6 Sun and Monday and then test on Tues. Would that be a good plan?
I wish I could find someone that knew more about managing my Coumadin! :eek: Can I manage my own?
Thanks again,
Deana
Click to expand...
Are you taking it 7 days a week? Your only showing 5. I would need to know the dose for the other two days if your taking 7 days worth.
 
denobobeno said:
Ross ( I was hoping you'd speak up)
They raised it from 8,6,6,8,6 to 8,6,8,6,8 until I get checked on Tuesday. I didn't feel like this was enough and told him so...but, he said he didn't want to raise me too much. I am doing my own thing and I took 8 Thurs. and I am not sure how much I should take tonight. I know it's going to be more than 6!
I'm just going on my past experience with my INR and I just didn't think what they told me was enough. I exercised today but, I won't do anything else until I know my INR is in check.
If I should raise it at least 10% (thanks Randy) then I guess I should take 10 Friday and Sat night then go to 6 Sun and Monday and then test on Tues. Would that be a good plan?
I wish I could find someone that knew more about managing my Coumadin! :eek: Can I manage my own?
Thanks again,
Deana
Click to expand...

Deana,
I meant raise it 10% of weekly dose. For daily, then divide that amount by 7 to find out your daily dose, assuming you are taking a dose 7 dyas a week.
 
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