effect of vomiting, diarrhea, and not eating much for a couple of days on INR

[Herb M]

Today I had the highest INR I have had for decades, 6.43. My normal range is 2.5-3.5. I vomited 4 times Monday morning and had diarrhrea the same morning. I ate very little for about 2 days,Monday and Tuesday. I did drink some Gatorade. For the past few days I had very little greens, but I usually do not eat much greens.

I will hold back the coumadin for two days (I already taken it today beore my blood draw). I will recheck in 3 days.

Anyone know if the vomiting and diarrhea and lack of eating earlier in the week could cause the high INR?

 

[ALCapshaw2]

Yes, Vomiting and Diarrhea can affect INR, either Up or Down, depending on when these occurred relative to when you took your Coumadin.

I don't have my Dosing Guide (from AL Lodwick) handy at the moment so I will let the Self Dosers chime in with their recommendations on dosing. (A 2 day Hold bothers me though as many who hold that long "Drop like a Rock".)

'AL Capshaw'

 

[Herb M]

Al, the Lodwick guide says hold dose and recheck in 24-48 hours. When theraputic reduce weekl ydose 15-20%

The aafp table says hold no doses or two doses. Reduce weekly dose by 10-20%.

I took my coumadin after the V and D episodes ended later in the morning.


I guess I will hold it for one day, tomorrow, and check in 2 days after the hold.

 

[olefin]

Diarrhea can cause INR increase. I found this out week before last on a cruise ship. I'd had diarrhea for couple days, I tested and had 6.1 INR. The ships doctor said it wouldn't effect INR, I didn't believe him. Went online and found it could raise INR.
I stopped warfarin for 2 days and started back at reduced dosage until I got over the diarrhea. I wasn't vomiting. Lasted 4 days, last 2 days on clear liquid diet but took wife and I a week to get back to feeling normal.
Lot's of folks on the ship had the same thing... we are very careful about cleanness. so we suspect the food.

 

[Ross]

For a 6.4, I'd hold two doses, then take a half dose and resume schedule. Only if the terror has ended though.