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How much Warfarin Amount do you take?

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Protimenow

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I think that I've written this before -- I'm currently taking 8 mg/day. Over the past few months, it's run from 7, to 7.5, to 8, depending on the results of my weekly test. These changes were slow (I didin't jump from7 to 8, for example), and careful. My target is between 2.5 and 3.5 -- if I got below 2.5, I would slightly increase dosage if this lasted for more than a week, if it ticked 3.5, I'd slightly reduce the dose. The goal is to stay near 3.0 all the time.
 

Astro

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I was told to take my warfarin in the evening. That makes sense for giving time to have a morning blood test and then get a clinic response in the afternoon. I changed to taking it in the morning because I self test and there is no delay getting a result. I can take medication more consistently in the morning (work occasionally goes to late in the evening). Also I prefer to take all my medication once a day. I also changed from metoprolol to atenolol so that became once a day as well.
 

pellicle

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I am surprised how high of a dose that is compared to everyone else.
it takes what it takes
15mg a day keeps me mostly at 2.5 - 3.5
I've heard of much higher.

660 mg per day.

Picture this - you go to visit your in-laws for Christmas and you forget your warfarin. You go to the ER and try to convince the doc to write a prescription.

Now if you were successful you trundle down to the local Walgreens to see if they have 7 bottles of warfarin 10 mg tablets on hand.
...My pharmacology textbook was copyrighted in 1960. It has only about 250 words about warfarin. It was the same text that medical students were using. This was 5 years after it was given to President Eisenhower. Just imagine the feeding frenzy that the news media would go into it it became known that President Bush took a medication that we only knew 250 words about.

I was giving a talk once in a small city where everybody in healthcare had covered for everyone else. They all knew a person who was taking 100 mg daily and was being managed by a hematologist at a university hospital.
 

Protimenow

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Taking your warfarin at night so you can see results in the morning makes no sense. Warfarin is slow acting - the effects of the dose you take today won't be detectable for 2 or 3 days (or more). No change will happen overnight.

Whoever told you to do this didn't know how warfarin works.
 

Warrick

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Hey not one size fits all..
If wafarins slow acting maybe some peoples metabolisms are faster...
Iv moved my inr from 1.6 to 2.4 in 12 hours by taking an additional daily dose first thing in the morning when Iv tested low ( flew to the other side of earth so 12 hr time zone wacko).
So I took 18mgs in one day instead of my usual 9mg, didnt over shoot either.

At the moment Im taking 9.5mg daily, least Iv taken daily in the last few yrs is 8.5mg daily and 10mg daily at the most.
My father takes between 2.5-3mg daily and hes been on the stuff for 36yrs.
 

jlcsn2015

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jlcsn -- I'm glad to see that you didn't say 'adios' to this forum.
>> As I've said on many other comments, it's best to take the same dose daily. You can pretty easily take your weekly dose, divide it by

Hi !, thank you for your notes and thoughts, i am sure it works for you 100%, as "For Me", if i take 3mg everday it just goes up and up beyond 2,5, and since i tend to keep it around 2, i do the 2.5/3 daily and works just fine "For ME", i am sure that 80% of the people will be as you say, no arguments, as per my own mini-world, it works just fine as i am doing this for 5 years now,

But, i would say your thinking applies in "General" and are very good thoughts,

There is no right and wrong,

Best regards,

jlcsn2015
 

tom in MO

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Taking your warfarin at night so you can see results in the morning makes no sense. Warfarin is slow acting - the effects of the dose you take today won't be detectable for 2 or 3 days (or more). No change will happen overnight.

Whoever told you to do this didn't know how warfarin works.
If you are being managed by a doctor or clinic, they want you to dose in the evening. As Astro said, this is because you call in your value or get tested in the morning, they you will get your new dose (if needed) during business hours and you can start your new dose the same day they tell you.
 

Protimenow

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I still have no idea what difference it makes if you take your warfarin at the same time each day - whether it's morning, afternoon, or evening. If you take it in the evening, a test in the morning will sure as hell not affect your morning test results. The clinics should know this. If they're ignorant enough to think that dosing tonight will make a change in your reading the next morning - you need to find a new clinic.
 

MartinF

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I have a tissue valve and also on warfarin. I take 3 mg M-W-F and other days 4.5 mg. Next time I talk to the cardiologist I will ask why I can't just take 4 mg daily (would go from 27 to 28 mg per week). My range is 2-3 and I'm in the low 2 range lately. I have the test at a clinic every 5 weeks as long as I'm in range. If out, it's 2-3 weeks. I've only been out of range a few times in 7+ years. I have different issues than mechanical valvers and I don't think my INR is as critical short term.
 

Protimenow

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MartinF - I'm not sure why you're taking warfarin with a tissue valve, but I'll leave that to your doctor to sort out.

If your INR isn't critical short-term, you may be okay NOT getting tested weekly.

I can't think of a good reason why your cardiologist wouldn't want to go with 4 mg daily - it's not going to change your INR very much. Also - because you stagger your dosage, your INR will be slightly different depending on the day you get tested. Taking a consistent daily dose avoids this issue.
 

MartinF

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I'm on warfarin because my body reacted to something on the tissue valve and started to cover it with blood. The leaflet eventually was too thick to move. Luckily my surgeon had seen this once before and had a good idea what to do. It took about 6 weeks for this to show up after going off warfarin post-op so that's why I say it's not as critical for me short term. My cardiologist also mentioned that fact.
I'll see my cardiologist in a few months and ask him about it. Another doctor in the group manages my warfarin but I think the cardiologist is the guy to talk to.
 

Jholt

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I'm on 13 a day. Started at 10 six years ago with aortic valve replacement at 45 years old. Seems to go up slowly every six months or so. When asked the cardiologist why he didn't have a solid answer, said maybe b/c I'm on the young side healthy and very active (until recently). Sucks as I'm now regularly nursing bruises from minor bumps that take forever to heal.
 

Cactus52

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I'm on 5mg a day 5 days a week and 7.5 2 days a week. Just got my own meter so I look forward to testing every week from here on out.
 

Superman

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Again, Superman, if you don't take the same daily dose, your INR will vary from day to day. Depending on which day you test, you'll probably get a slightly different value. If you change your dosage based on the value when you test, you may wind up slightly over- or slightly under- dosing.
I missed this until the thread was bumped. Or I probably thought the better of responding at the time. So if I’m supposed to be between 2.5 and 3.5 and two weeks in a row I test at 2.3. I’ve been taking 6mg daily during that time. How would you suggest I divide a 1 mg tablet seven ways so I can take the exact same dose daily? If I go to 7 mg daily, I’m going to shoot way past 3.5.

As long as that daily variance keeps me somewhere between 2.5 and 3.5 - I prefer not to split pills and to stay as close to even as possible daily, but I don’t worry about a 1 mg here and there. Diet, exercise, sleep, etc will all factor in to daily fluctuations as well. I have a very long track record of testing in range and I’ve been taking this over 30 years now. Really have no idea what you are (or rather, were) trying to correct me on.
 

dick0236

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At age 85 I now take 5mg/day with a small adjustment dose of +/- 2.5mg a few times a year. When I was young, in my 40s/50s I took +/- 10mg daily......I was a lot more physically active then🤪.
 

RAS

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I take 42mg / week, 6mg daily. I've taken more in the past, but seldom less. As others have noted, the amount is not important as long as you are able to stay in range consistently. My first year (mid-2006 to 07) I was managed by an anticoagulation clinic. My experience was they were too quick to make dose changes. As a result my in-range average was only 57%.

In 2007 I was diagnosed with fibrin strands on my valve so my cardiologist narrowed the target 3.0 - 3.5 and added a daily aspirin. I asked to start home testing because I had no confidence the clinic could manage to that range. My cardiologist agreed as long as I reported my INR each week. I was not doing my own dosing, but was able to move my average up to 70% in range. I sometimes argued with the nurse when she requested dose changes I considered unnecessary. By about 2010 I got permission to manage my own dosing. Eventually the strands went away and they set the target back to 2.5-3.5.

Like just about everyone, I've had to at times split pills, have a variety of different sizes on hand and take different amounts some days, but over time I learned the more consistent my daily dose was, the more consistent my INR. The split pills always concerned me, because I doubt the warfarin is evenly spread through out the pill.

I tracked daily vitamin k intake for awhile, but that became rather tedious, however I did learn that I could more easily move my INR in small increments by simply adding or subtracting salad each week in between INR readings.

That is my preferred method of managing low/high INR. In 2019, I was in range 84%. In 2020, 100%.

Overall, these are a few things I've learned that help maintain my INR
1. Mitigate risk of missing/doubling a dose: Use a pill box and take the pill at the same "time" every day whether that be a specific hour of the day or a specific event like bedtime.

2. Take a consistent daily dose, ideally without splitting pills.

3. Be aware of your eating habits especially anything that may change your vitamin k intake and be pro-active in checking your INR during times when you may have a significant dietary change. For example, we went on a cruise a few years ago and I returned with a 1.8 INR! I'll take my meter with me next time (if we ever get on a cruise ship again).

4. Manage small over/under INR readings by adding or subtracting vitamin k rich foods rather than changing the dose.
 

tom in MO

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I do 4.5 MWFS and 4 on T, TH, and now Sat. For me at 4.5 a day my INR progressed upward and at 4.0 a day it progressed low. My target range is 2-2.5 and I home test and dose.
 

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