Advice please

[Robbyn]

My clinic nurse has not called me back and I am not sure what to take when my INR is 6.7. Last week it was 3.6 and I take 11.50 mgs per day.

The doctors office said to hold it for 3 days...but that doesn't seem right.

TIA,
Robbyn

 

[Eva]

Robbyn, I am not sure what to tell you, as I am a novice still!! but when mine went up to 7.5, my doctor asked me to skip one day only. I was taking 10 mgs at the time. I am sure more experienced members will be more helpful.

 

[Bridgette]

Gosh, I would NOT hold for 3 days!

This is what I would do - based on Al Lodwick's dosing guide instruction chart:

Hold one dose.
Retest in 24 hours.

If therapeutic, restart at 15-20% less than previously then recheck in 3-7 days.

Last week my INR was 5.1 so I did what is described above and I am pretty much back within range now.

My cardio told me that when I have spikes like that just to make sure that I test a bit more frequently till I am back within range. (I am home testing)

Good luck
Bridgette

 

[njean]

Ummmm, I would not dare hold it for 3-days, maybe 1 day & then half the dose for the next 2 days & check again on the 4th or 5th day.

Holding it that long is just too long.

 

[Ross]

For 6.7 I would withhold 2 doses and half the next dose, but the question is, what was the total weekly dose you took to achieve this 6.7? If it was 11.5mg per day, then drop the total weekly dose by 10% which would make it 10mg everyday rounded off. Be sure your retested in 4 days. General, the more you take, the faster you fall with missed doses, but 6.7 is getting up there, so I think holding 2 is appropriate. Not a doctor, but that is what I'd do.

 

[netmiff]

Don' ever hold 3 doses, warfarin is metabolized in under 3 days; at the end of the three days, it would be as if you had never, ever taken any (well, close to it anyway).

Robby, as I am in Ontario, too, I would like to know who is managing your dosing. Please PM or e-mail me.

 

[Robbyn]

Thanks for your help

Thanks for your help

I held my Warfarin yesterday and will hold it again today. Tomorrow I will take 10 mgs and test on Monday.

My doctor does not manage my Warfarin. An anti-couagulation clinic does, we just didn't connect yesterday.

Thanks again, not sure what I would do without the help I get here.

 

[Karlynn]

A doctor or manager telling you to hold for 3 days is basically telling them that they want all anticoagulation out of your system.

11.5 mg is a fairly high dose and your system will purge it quickly. When I was over 6 back in Feb I held one dose, took 1/2 dose. My INR was back in range the day after the 1/2 dose. I take 10/day.

Sorry for disagreeing with the always knowledgeable Ross

- but I think holding 2 days and taking 1/2 dose on the 3rd will take you into the 1.0 -2.0 range since you've been taking over 10 mg/day. (The higher your dose, the more quickly your INR drops when doses are held).

Depending on how long you've been on the 11.5 dose, I'd either drop my dose by 10%, or resume normal dosing and retest in 4 days. When I had my 6.0 INR - it was a total fluke and my usual dose was fine after the hold and 1/2 dose.

 

[Ross]

Ouch, I've been burned!

 

[Karlynn]

Ouch, I've been burned!

and did you enjoy it????????

 

[Ross]

and did you enjoy it????????

I don't know, it was too quick. .....and you women blame us men for that.