Dad's INR is 1.8

[Jiddo]

Hi All.

My dad just came back from Vegas and tested his INR yesterday and it came back at 1.8. What do you think about just increasing 5% for the week and re-testing in 1 week? The pharmacist wants to give him a "super dose" of 4 pills (20 mg today) and keep him on his regular schedule for the rest of the week (3 days at 12.5 mg and 3 days at 15 mg), totaling 102.5 mg. He was previously taking 97.5 mg before Vegas and had an INR of 2.7 before he left.

The pharmacist said we have done a lot of changes over the last several weeks with his dosing so she only wants to change his dose for today and keep the rest of the daily doses the same as before. However, I was thinking more along the lines of an 8-10% increase for the week.

However, with that said, the last time he was at 102.5 mg for the week, he had an INR of 3.4. So, maybe we do make a smaller adjustment and see what his INR is next week when he is back to his regular schedule?

Your thoughts?

Thanks!
Jennie

 

[Karlynn]

If he was in Vegas, I'm guessing his activity was more than normal.

I think either would work. What would his normal dose have been today? 12.5 or 15?

 

[KristyW]

Pharmacist ok

Pharmacist ok

Jennie,

Since your dad was away "on holiday" he was doing more walking and eating different things. It's quite normal for an INR to be different when we're not doing our normal routines.

The pharmicist is giving ok instructions as long as your dad hasn't been on a downward trend to this point. She's increasing his previous dosing by less than 5%. I think it's a good plan. Remember 3.4 is not a high INR. Kaiser Permanente here in the Denver area considers 2.0-3.5 as "in range" for an Aortic Valve and 2.5-4.0 for mitral. So either dose is probably ok for him.

 

[Jiddo]

Hi Karlynn and Kristy,

Thanks for your feedback. Karlynn, my dad's regular dose today would have been 15 mg (3 pills). So, they are bumping it up to 4 pills or 20 mgs.

This happened last time my parents were in Vegas. My dad left with an INR of 2.7 and came back with an INR of 1.9. He actually upped his dose slightly while he was in Vegas, knowing what happened last time.

Thanks again....I feel better about the plan of action.
Jennie

 

[catwoman]

Jennie:

Make a note that when your dad goes off to Vegas (or on vacation somewhere else), his INR will most likely drop below range. Record what is done to bring it up to range.

Next time, go back to those records and review them.

Yesterday, I went back over my INR records for the last 4 years and saw notations explaining drops/jumps in my INR. Also realized that I am recharging my ProTime 3 every 6 months. (I've recorded that.) I recharged my ProTime 3 overnight on 1/8-1/9, so I expect to need to do so again in August 2008.

That's the value of our INR records. You can review your dosages, illnesses, INR values.