Concern About My Dosage

[MichelleS]

Hi everyone,

Just wanted to get opinions on my recent INR results and the dosage my doc has told me to take.

I take a fairly large dose of coumadin in the first place because I'm on a seizure medication called Tegretol. I was steady for quite a while taking 8 mg per day. Two weeks ago my INR was 2.3. My doctor told me to take 10 mg per day on the following Monday, Wednesday and Friday and the usual 8 mg the rest of the week. He also told me to test again in a week.

I took the 10 mgs three times and 8 the rest, but waited ten days to to get tested because during the middle of that week I went to the dentist and it's been my experience that the antibiotics impact my INR.

To make a long story short, I tested Monday and the result was 3.1, which is right in range. However, my doc wants me to continue the 10 mg. three times a week and get tested again in two weeks. (To be honest, I was to take the 10 mg on Monday but had already taken my 8mg before they called and didn't take the extra 2.)

I'm just a bit concerned about him bumping up my daily dosage that much when I'm in range. Am I worrying too much?

Thanks in advance for any feedback. Hope everyone is well.

All the best,
Michelle

 

[Ross]

I'd continue with what the Doc ordered, but when you test again, be sure to tell them about the 8mg dose that should have been 10. I don't think it's a big deal, so long as they know exactly what you've taken.

ooppss, I missed the Tegretol part! My bad. Thanks Al.

 

[Guest]

This can be a very dangerous combination. It is worse if the carbamazepine is newly started because it can start inducing its own metabolism and this throws everything off.

Please look at http://www.warfarinfo.com/carbamazepine.htm

 

[MichelleS]

Concern About My Dosage

Hi Al,

Thanks for the great information. I've been on Tegretol for about a year and a half. It took them a few weeks to stablize my INR initially, but since then I've been pretty lucky overall. I was just concerned that adding an extra 6mg of coumadin per week even for a couple of weeks seemed a bit much when my INR is in range.

Thanks again.

Cheers,
Michelle

 

[Guest]

Generally your dose should only need to go up or down by 10-15% (rarely 20%). Bigger jumps than that make you wonder if the person dosing your warfarin has any idea what they are doing.