coumadin vs. generic

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Consuela

Active member
Joined
Oct 7, 2005
Messages
43
Location
New York
I have been on a generic for coumadin (wafarin) since I had my valve replacemnt operation 5 years ago. Lately my INR readings are on the low side (I usually am low rather then high) and I was directed to change my dosage and the reading is still low.

My question is that could it be the manufacturer of these generic pills since I am usually on the low side or should I get the coumadin prescription from my doctor and fill it and see what happens.

I have to be 2.5 to 3.5 and I am usually around 2.3 or 2.5

With the increase it was 2.0. How can that be?

One more quick note is that I am in Florida and useing a lab where as when I am home I go to the doctor and they use the finger stick and get the results on the spot and he changes the dosage if need be.

Thank you,
mitral valve replacement 12/13/2005
 
Consuela:

1. Usually around 2.3 or 2..5 isn't great. If your INR range is 2.5-3.5, you should be working to get it higher. Most of us who have a range of 2.5-3.5 prefer to be in the middle, if not at the higher end of that range.

2. Is the lab using a vein draw vs. the finger stick at your doctor's office?

3. When will be able to go back to using your doctor's office?

What was your dosage before you changed it? What is it now? (Daily dosage -- give the pattern, if it's not the same each day).

I would not think that using trademark drug vs. the generic would help. Something else is going on. My first guess is that you're not at home and your daily habits have changed. I switched from Coumadin to generic perhaps 5 years ago and have not had problems. I home-test and use an algorithm dosage chart to make my changes and it's worked very well.

Someone else may have other questions/thoughts.
 
I took coumadin for 17 years, last year switched to warfarin... no change other than the changes I've always seen.

Labs will sometime vary on readings. I travel for several years and used a different out patient lab each month.... I saw some strange numbers.. but I was probably eating different also. Should have been home testing back then.
 
coumadin v. generic

coumadin v. generic

catwoman said:
Consuela:

1. Usually around 2.3 or 2..5 isn't great. If your INR range is 2.5-3.5, you should be working to get it higher. Most of us who have a range of 2.5-3.5 prefer to be in the middle, if not at the higher end of that range.

2. Is the lab using a vein draw vs. the finger stick at your doctor's office?

3. When will be able to go back to using your doctor's office?

What was your dosage before you changed it? What is it now? (Daily dosage -- give the pattern, if it's not the same each day).

I would not think that using trademark drug vs. the generic would help. Something else is going on. My first guess is that you're not at home and your daily habits have changed. I switched from Coumadin to generic perhaps 5 years ago and have not had problems. I home-test and use an algorithm dosage chart to make my changes and it's worked very well.

Someone else may have other questions/thoughts.
Click to expand...

First I want to thank all of you for your quick replies.

IIn answer to your questions. I have here in Florida vein draw. At home it is the finger stick. I guess it has ranged from 2.5 to 3.i and then it goes to 2.3 and then 2.4.I have been on the low side of 2.5 I guess.

My latest dosage is 5mg every day except Saturday it wil be 2.5 I go again next week for another vein draw. I will see what that brings. I used to be on 2.5 everyday and 5 mg. on Wednesday and Sunday.

I have been on the low side of 2.5 and not on the high side for as long as I can remember.
 
The easiest way to regulate Warfarin dosage is to total up the dosage for a week, and find tablet combinations that allow small changes in that total.

The two cases that you report in your posting shows your latest dosage is 32.5mg/week, up 44% from the previous dosage of 22.5mg/week. This is quite a large change to make, and your INR may be too high. If you need to change again, try to find combinations that allow smaller changes in the weekly total.

I find it handy to print out a blank chart showing each day, and post it on the side of the refrigerator. I then fill in my plan for the week, and check off each day as I take the tablet. I also enter each INR number on the day it occurred. This serves as a reminder when a new reading is needed.
 
Last edited:
Too Low?

Too Low?

Too low? Well, you can do charting stuff like many others do here or you can simply increase your dosage to bring yourself to middle of your range. Opinions will vary, but I approach dosing from the perspective that if I'm lower than I need to be, I increase my dose; if I'm too high, I reduce the dosage. Since my cardiologist has prescribed coumadin in both 2.5 mg and 5 mg, I usually do dosage changes in small increments.

Differences in regular coumadin and generic? I've never seen any differences. I believe the FDA requires that the different versions of the drug function the same way.

The largest impact I see on my INR involves my metabolic rate. Mine fluctuates a lot when school is in session because my work schedule doesn't allow me to get into a regular exercise program. Some of the folks here seem to have "rock solid" INR's; I've never had than experience. Our bodies just function function differently.

-Philip
 
This issue has been discussed many times. Some have had no issues going from brand to generic, but some including myself had problems with the generic. So after almost 14yrs on the brand, I will stick with it.
As for your problem I beleive after five years it has nothing to do with brand or generic.
Has your activity level changed? Have you added or removed any other medications?
Any diet changes?
As far as increases to your dosage, I strongly recommend using the 10% rule to change your weekly dosage.
Rich
 
OldNick said:
The easiest way to regulate Warfarin dosage is to total up the dosage for a week, and find tablet combinations that allow small changes in that total.

The two cases that you report in your posting shows your latest dosage is 32.5mg/week, up 44% from the previous dosage of 22.5mg/week. This is quite a large change to make, and your INR may be too high. If you need to change again, try to find combinations that allow smaller changes in the weekly total.

I find it handy to print out a blank chart showing each day, and post it on the side of the refrigerator. I then fill in my plan for the week, and check off each day as I take the tablet. I also enter each INR number on the day it occurred. This serves as a reminder when a new reading is needed.
Click to expand...
Again I want to thank all of you.

I am only on the 5mg every day and 2 1/2 for one day for a week and I go on Tuesday for another reading. I have not done anything differently. Since my operation I have had to go and get checked often for it never stays in the range and is on the low side. I have been taking 2 1/2 with 5mg twice in a weeks time for the longest time. So hoping that the next reading will be better. If it goes way up(which I don't think it will) we will have to change the pattern again and another test will be in order.So we shall see. Again thank you for all your input.
Consuela
 
Consuela said:
Again I want to thank all of you.

I am only on the 5mg every day and 2 1/2 for one day for a week and I go on Tuesday for another reading. I have not done anything differently. Since my operation I have had to go and get checked often for it never stays in the range and is on the low side. I have been taking 2 1/2 with 5mg twice in a weeks time for the longest time. So hoping that the next reading will be better. If it goes way up(which I don't think it will) we will have to change the pattern again and another test will be in order.So we shall see. Again thank you for all your input.
Consuela
Click to expand...

Consuela...are you sure that you haven't started or stopped any vitamins, medications or liquid supplements? It might just be the change of scenery. You've gone from New York to Florida. Travel seems to make most of go out of our range. We're doing more walking, eating different foods, etc.

Just to let you know, I've gone from 35mg/week after my valve replacement to 60mg/week about 4 years ago, back down to 35mg/week for the last 3 years until my hysterectomy in October, to 47.5/mg since October. Your INR can and will vary. It's just the nature of the drug.
 
KristyW said:
Consuela...are you sure that you haven't started or stopped any vitamins, medications or liquid supplements? It might just be the change of scenery. You've gone from New York to Florida. Travel seems to make most of go out of our range. We're doing more walking, eating different foods, etc.

Just to let you know, I've gone from 35mg/week after my valve replacement to 60mg/week about 4 years ago, back down to 35mg/week for the last 3 years until my hysterectomy in October, to 47.5/mg since October. Your INR can and will vary. It's just the nature of the drug.
Click to expand...

Kristy... I am not doing anything differently. I don't eat different foods and I walk a lot just like I do in North Carolina (I moved there three years ago) The lab is different and I was always on the low side of 2.5. I know this is something that has to be checked forever and I just hope this dosage is the right one for now. I am sure it will rise and they will put me back down again. I will know next Tuesday. Thank you for your support.
Consuela
 
I just got my PT-INR and it is 3.3 This is the first time in such a long time that I am on the high side of the range which is 2.5 to 3.5. I will go again in a week to see if it levels off or is I have to reduce it. I am not going to change this medicine manufacturer if I can help it. Thanks to all for your concern.
 
Consuela said:
I just got my PT-INR and it is 3.3 This is the first time in such a long time that I am on the high side of the range which is 2.5 to 3.5. I will go again in a week to see if it levels off or is I have to reduce it. I am not going to change this medicine manufacturer if I can help it. Thanks to all for your concern.
Click to expand...

Its nice to see that you got a response from your medication change. I agree that it needs to be watched, to be sure that it doesn't continue to rise. Just be sure that, if they change the dosage next week, they don't reduce it more than 10 or 15%.
 
Consuela said:
I just got my PT-INR and it is 3.3 This is the first time in such a long time that I am on the high side of the range which is 2.5 to 3.5. I will go again in a week to see if it levels off or is I have to reduce it. I am not going to change this medicine manufacturer if I can help it. Thanks to all for your concern.
Click to expand...

Consuela:

Reduce it? It's PERFECT!!!!!!!!!!!!
 
Consuela said:
I just got my PT-INR and it is 3.3 This is the first time in such a long time that I am on the high side of the range which is 2.5 to 3.5. I will go again in a week to see if it levels off or is I have to reduce it. I am not going to change this medicine manufacturer if I can help it. Thanks to all for your concern.
Click to expand...

Unless your 4.0 or higher, I wouldn't change a thing!
 
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