5.8 inr

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cocoalab

well I am back picking your brains. Andrew's INR went from 2.4 on the 4th to 5.8 on the 23rd of this month. We skipped his dose last night and was told to either test it again tonight or skip another dose and retest next week. I think that is too many skips. I agreed to it but after thinking about it I told Andrew it seems like it would be wiser to do half doses tonight and tomorrow night and go to regular dosing after that and then test next week.

No major changes except a flu shot which I failed to mention, but that was a week ago. His normal dose is 3mg 5X a week with one day of 1.5. ( 19.5 mgs)We may change to 2 days of 1.5 as he tends to drift up. 2.5 is the lowest he's gotten since the middle of July when he dropped to 1.4.
 
Wendy:

I probably would have waited 4 days and retested without having cut his dosage, just in case this was a "blip."

Any changes in his meds, actvity level, etc? Any possibility he's accidentally taken a double dosage?

Since you've already skipped one dose, I'd wait about at least 48 hours to retest. Testing tonight won't tell you much -- too soon after the skipped dosage.
 
I would probably go with your plan....if it were me. The only reason to test tonight would be to make sure the high INR wasn't a fluke. Maybe the flu shot does have an effect on him. Changing his weekly dose as you mentioned is subtle enough to not get him yoyo-ing but may give the effect you hope. Since you already held one full dose than holding a half may do the trick. Better a bit over than under. That is what I would do ...if it were me.:rolleyes:
 
I know when Tyce is high (in the 5's or 6's) we'll skip one night and then go back to regular dosing. He doesn't usually halve a dose for two nights. Usually one skipped dose will bring him down by half. I would definitely retest but only in three days. Rossman always tells me that it takes that long to take effect in your system.

Hope it helps.

Evelyn
 
Yep that is what we did. did half dose last night and tonight. I will retest on monday when we are back from our Thanksgiving travels. We will see how it went then. thanks all!
 
Down but still too high!

Down but still too high!

I wasn't sure whether to post here or start a new thread. But anyways...

Andrew retested yesterday and is still a bit high 4.8 I think. We had dropped one dose and then did half doses 2 nights in a row but he did not do another half dose on sunday like he usually does. At least he doesn't think he did. :rolleyes:

We would really like to drop down to 3.5. I had him skip last night and am waiting to hear from his nurse on what she would like him to do. What is the rule of thumb as far as how much percentage he should be dropping to get in his range of 3 to 3.5 if he is at 4.8 INR and took 12 mg and has dropped from an INR of 5.8 and was taking 19.5 mg of warfarin? Is there a rule of thumb?
 
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