Inr 4.0

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Dave S

I will start of with dosing I was taking 55mg per week....7.5 for six days and 10mg one day

I had my INR checked 3-4 weeks ago INR came back 5.5.....Doc sts to skip 2 days... and lower my dose to 7.5 per day (total 52.5mg per wk)

I had INR checked today it was 4.0....doc sts to skip 2 days and lower dose to 7.5 for 5 days..(37.5mg perwk) and recheck in two weeks.

I never like skiping two days..I do not mind one day to much.....my question is what doising should I be following...I was thinking to skip one day and lower dose to 7mg a day (48mg per week).

I have been taking 55mg per week for six mths now all of a sudden I am high what would be causing it...I was exercise alot and quit due to a backache about 1.5 mths.

Thank youfor the help
 
I think you are on your way down already. An INR of 4.0 does not warrant a 2 day hold. I would have myself a nice salad and resume the decreased dose your MD already implemented. If you go for another decrease. You may be too low. Retest in a week:)
 
I am not an expert at this but by my reckoning I think your plan sounds much more reasonable than the one 'they' suggest, even then I dont think I would skip any doses. I have found that for me, adjusting the dose by about 10% of the weekly dose avoids the yo-yo affect.

I would guess that dropping your exercise routine has caused you to metabolise warfarin slower therefore bringing about a bit higher reading. You could well need to adjust your level permanently to account for your lack of strenuous exercise.

Good Luck and let us know how you go.
 
I agree with the others. I'd just continue on the dose that got you to 4.0. Like Gina said, I'd enjoy some salads and I'd also retest in a week to see if it's continuing to go down. Was your doctor's instructions to only take Coumadin 5 days a week? If so, that's not a great plan. Maybe for someone who is only taking 1 mg a day, but for someone who take 7.5/day, missing days as a routine is not a good thing.

I think you are most likely on target when you say that the stopping of exercise caused the increase.
 
Your Doctor is WAY OVERREACTING to a 4.0 Many people, especially those on higher doses such as yourself, find that a TWO DAY HOLD causes their INR to Drop like a ROCK. At 4.0, I would not even hold for one day. Some patients who are at risk of stroke are advised to maintain their INR at 3.0 to 4.0.

A moderate reduction (maybe 5%) in your weekly dose might be all that is needed. Check again in 1 week. I agree that stopping your exercise program is the likely cause of your INR rising.

The SAFE RANGE for INR is from 2.0 to 5.0 and many do not experience bleeding even at 8.0

'AL Capshaw'
 
Dave S said:
I will start of with dosing I was taking 55mg per week....7.5 for six days and 10mg one day

I had my INR checked 3-4 weeks ago INR came back 5.5.....Doc sts to skip 2 days... and lower my dose to 7.5 per day (total 52.5mg per wk)

I had INR checked today it was 4.0....doc sts to skip 2 days and lower dose to 7.5 for 5 days..(37.5mg perwk) and recheck in two weeks.

I never like skiping two days..I do not mind one day to much.....my question is what doising should I be following...I was thinking to skip one day and lower dose to 7mg a day (48mg per week).

I have been taking 55mg per week for six mths now all of a sudden I am high what would be causing it...I was exercise alot and quit due to a backache about 1.5 mths.

Thank youfor the help
Click to expand...

Dave I would not hold anything, but I think lowering your dose to 48 for the week is reasonable. I'd try that and see how it works out on the next test. If you hold 2 doses at 4.0, your setting up for yo yoing as you'll fall well below therapeutic level.
 
Dave:
I don't understand your doctor's panic with an INR of 4.0. It is beyond your range, however, there are many people, like my husband who have a range of 3.0 to 4.0. That is the common range for one who has had a stroke while on Coumadin. Years back, there were times when Al held for a day or two and each time his INR bottomed out. Holding for and INR of 4.0 is not wise at all for us. Maybe you could think about some V-8 or a big spinach salad and a decrease in your Coumadin intake of 10%..which I think would be 5.5 spread over the week.
Kind regards,
Blanche
 
Hi Dave,

Chiming in a little late but........ I agree with the others, holding doses at 4.0 is just asking for more problems. My range is 3.0 - 4.0 so I don't even worry when I have a 4.6 INR. Although I realize your range is lower, I bring this up to show you that 4.0 is no big deal.

I would stay on the 7.5/day (that is what you were taking when you got down to 4.0, correct?) and retest in a week. As Gina said you may still be dropping some and you wouldn't want to drop below range. If you are still high next test, you can adjust from there but you will not be in danger at 4.0.

I also agree with Karlynn that the exercise stopping is probably what caused your INR to increase.

Things will work out and you will find a good dose for your current lifestyle.
 
Thanks

Thanks

Thanks for all the help....I tell you these doctors just scare me when it comes to INR and meds. They just do not seem to have a grip.

This is what I am going to do.

Since I was taking 52.5 mg per week, I am going to lower my dose to to 47.5 mg per week,and go from there.

I now have another question?:rolleyes:

To do this I need to take 7.5 mg 5 days and 5mg for 2 days my question is
should I brake the 5 mg days up during the week or does it matter to take it in 2 consective days in a row?

Thanks again
 
Dave,

You should take the 5mg tablets a couple of days apart (like Mon. & Thurs.).
 
New Update

New Update

:confused: ...I had my Inr checked this morning it is now... well they did it two times.....The first time it was 6.0....the second time it was 5.7. i went up frpm 4.0.

How did this happen?...I lowered my dose I was exspecting it to be close to normal.....My doctor was thinking that maybe I switched to coumaden from warafin (sp) which is not the case. anyone have any ideas?...I did have two very small pieces of brocolli the other day????

My doctor now wants me to lower my dose from 47.5 per week to 40mg per week. is this this to much of a drop? I feel I am ok doing this dosing Just dont like skiping days.

Thanks again
Dave
 
Dave S said:
:confused: ...I had my Inr checked this morning it is now... well they did it two times.....The first time it was 6.0....the second time it was 5.7. i went up frpm 4.0.

How did this happen?...I lowered my dose I was exspecting it to be close to normal.....My doctor was thinking that maybe I switched to coumaden from warafin (sp) which is not the case. anyone have any ideas?...I did have two very small pieces of brocolli the other day????

My doctor now wants me to lower my dose from 47.5 per week to 40mg per week. is this this to much of a drop? I feel I am ok doing this dosing Just dont like skiping days.

Thanks again
Dave
Click to expand...
Dave is there another lab you can test at? This isn't possible unless your taking some other drug that your not telling us about. Let us know everything that goes into your mouth.
 
I know it does not make since.......here is what I am taking.

- Warfarin
- Zocor (Simvastatin) 40mg been on this for over a year.
- Tricor 145mg.......I have been on this for approx. 7 weeks

Now I kinda watch my diet, but I have been enjoying a few salads lately other then that nothing more then I have been doing for over a year.

So the only thing different is the Tricor could this be the cause and the non-exercising?

I have tested at a different lab closer to my home every now and then, but the readings are always close to my doctors....he uses the INRatio and it always seems to work fine.
 
I've found that if I stop my exercises becuase of the weather or getting busy with other stuff, my INR goes up about 2-3 INR numbers. Also, if my wife does the cooking, it'll go up because she's not a big veggie fan.
 
To Dave

To Dave

Dave , hi I went to my dr last week my INR was 4.0 which is no reason for drs to panic he felt a hemotoma on my back called ER and got me a bed , I couldnt believe they put me into the hospital for 24hrs. im taking 3 migs each day of the weeks and began to have lots of pain in muscles and brusing
 
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