Here We Go Again......INR???

[Freddie]

Okay here's the question

INR was 3.1 two weeks ago
Last week 3.2
Today it's 3.5
I've stayed on my 6mg for the last 3 weeks.
Is it possible that I'm having something that is raising my INR levels?????
If not, I'm thinking of taking 5.5mg until next Monday ( thats when I'll be going back to the lab for bloodwork).
I sure would like some answers, but PLEASE don't reply in % form. Either I cut a pill in half or a don't. Lets keep it simple gang, cause I'm a simple kinda a gal.

Thanks a Bunch,
Freddie

 

[PJmomrunner]

Freddie, you might want to post what your range is. The INR patrol will weigh in soon, but what you've posted doesn't look like much of a fluctuation to me.

 

[Karlynn]

Just my opinion, but I wouldn't do a thing. A 3.2 to a 3.5 is a non-issue. You could very well be lower next week on the same dose or it could be a little higher. I wouldn't start monkeying around with it yet. Is your range 2-3? Right now, you are not experiencing enough of a jump in INR's week to week to start assuming that your dose is too high for you. It could be weather, it could be a little decrease in activity, it could be anything, only one of which is that the dose itself is too high with everything else stabile.

If you had said it was 4.0, then I'd tell you to decrease it by 10% if your range is 2 - 3. And yes, you need to start thinking in terms of weekly percentages because that is the correct way to adjust your dosing.

Just an FYI. I'm taking 70/week, 10/day. 3 weeks ago my INR was 2.8, a week and a half ago it was 3.7, today it was 2.6. All on the same dose, with me just living my life. All INR's are okay with me and I didn't do a thing to my dose. Some inexperienced people would look at those numbers and say I'm not stable. I'm in range, so for me, that's stable. I don't watch what I eat (as far as "Coumadin friendly food" goes). I really don't make any adjustments for the fact I'm on Coumadin other than I'm careful about my ibuprofen use. If the trade off is a fluctuating INR that's in range or swings a bit outside to the higher end (my dose is such that it won't let me go low), then it's a great trade-off.

A big mistake some folks make is thinking their INR shouldn't vary more than a few points week to week if they are on the same dose. A few unusual people here will tell you they are as stable as that. Most of us are not.

 

[Bina]

Freddie, you are still in range.

You can wait until Monday's test or if you would like to lower it just a bit then take 1/2 pill (3mg) just for one day.
Either way you will be just fine.

I keep two doses on hand ....I have 2mg and 3mg.

 

[Freddie]

Sorry Guys, but my range is 2.5 to 3.5
Please don't put me jail.

Freddie

 

[Freddie]

Freddie, you are still in range.

You can wait until Monday's test or if you would like to lower it just a bit then take 1/2 pill (3mg) just for one day.
Either way you will be just fine.

I keep two doses on hand ....I have 2mg and 3mg.

I didn't realize they made 2mg. But THANK -YOU for replying in 1/2 dosage......not percent.
For one day 1/2 of a 3mg pill, will that make a real difference?

 

[Bina]

Just so you know why:
6mg pill daily for 7 days= 42 mg each week

If you wanted to make a small adjustment of 7%....that would be 1/2 pill.

It is a small adjustment, nothing drastic, because you are not really too high yet, but you are showing a pattern of increase.

Remember alcohol and lots of irregular consumption of greens will affect INR.

 

[Karlynn]

Freddie - don't fall prey to the unknowing portion of the medical community out there that freaks out if your INR is on the higher end of the range. Since you are in range - do not do anything! Just because you are seeing a slight trend upward doesn't mean you are going to sky-rocket all of a sudden.

Even if you get to 4, most of us would recommend staying at that dose and seeing what it is in another week.

INR is NOT an exact science. If you'd tested again today right after the first test, you would have had a different #. 2 lab tests using the same tube of blood will get 2 different INRs.

 

[Karlynn]

I didn't realize they made 2mg. But THANK -YOU for replying in 1/2 dosage......not percent.
For one day 1/2 of a 3mg pill, will that make a real difference?

Why do you want to do anything? You're in range. There's no need to lower anything right now.

You should be happy - you've had 3 consecutive tests in range.

Stop worrying and have a little celebration!

 

[Freddie]

Remember alcohol will affect INR.

LOL
Got it

 

[ALCapshaw2]

Freddie,

Those numbers are ALL IN RANGE.

Therefore make NO CHANGES in your dosing.

Don't forget, there is a Range of Tolerance to ANY type of INR Test. You could get that much variation on the Same Day with different machines.

IF you are concerned about being on the high end of your range, Eat a Spinich Salad or some such source of vitamin K. ENJOY !

One Graph of Risk versus INR that I have seen is FLAT from 2.0 to 5.0 Note that the Risk of Stroke goes up for values below 2.0 and the Risk of Bleeding goes up for values above 5.0. Anything in-between is just fine for Aortic Valve recipients. For Mitral Valve recipients, a slightly higher range (2.5 to 3.5) is recommended.

I would not be worried even with an INR of 4.0 Above 4.0 I would probably make a SMALL adjustment (of 3% / week). I have pills of TWO different doses (3 and 4 mg) which makes if very easy to make changes of 1 mg/week merely by varying the weekly allocation. With those two doses I can get anywhere from 21 to 28 mg / week with only ONE pill per day. (I also have some 'samples' of 1 mg pills as a backup or alternative means of making adjustments).

'AL Capshaw'

 

[Freddie]

Freddie,

Eat a Spinich Salad or some such source of vitamin K. ENJOY !

'AL Capshaw'

Thanks Al I will. it's probably due to my decrease of activity as mention by Karlynn. Its been so cold here lately and I got lazy.

I won't change my dosage.

Thanks for all your input guys............appreciate it

Freddie

 

[Ross]

Freddie this is what is known as a STABLE INR.

 

[lance]

Don't change your dose and .............

Don't change your dose and .............

Hui Freddie,

Our INR range is the same and I wouldn't change your dose..just eat more greens like Al recommended.

Warfarin comes in 1 mg tablets and I recommend one of those little pill splitters to severe a 1 mg into two 1/2 mg doses when required.

Now, not to hijack this thread what breed of dog is represented on your avatar?

Best wishwes for remaining stable with your ACT.

 

[Karlynn]

Now, not to hijack this thread what breed of dog is represented on your avatar?

I'm guessing (and I get a prize if I'm right - but not from Ross)

Is it a.... King Charles Cavalier Spaniel????

 

[Freddie]

Karlynn, Your Right!!
I used to breed these little darlings in my younger years. I just sent PM to Lance telling him so.

As for your prize. I have a smashing recipe for a taco salad.

Freddie

 

[Karlynn]

Karlynn, Your Right!!
I used to breed these little darlings in my younger years. I just sent PM to Lance telling him so.

As for your prize. I have a smashing recipe for a taco salad.

Freddie

I love taco salad - send it on!

 

[bvdr]

Sorry Guys, but my range is 2.5 to 3.5
Please don't put me jail.

Freddie

Freddie, don't change a thing. My range is 2.5 to 4.0 (one doc says 2.5-3.5 and the other 3.0 to 4.0). I prefer being in the higher end of my range but I don't tweak my dosage at all unless I'm out of range. Don't try to fine tune it very much or you'll just drive yourself crazy. Be happy anytime you are in range.