I am back.

[Robbyn]

I am the Thanksgiving person who over the holiday's managed to miss my warfarin 2 days in a row. I missed Sat. and Sun. and took a dose and half on Monday and Tuesday.

Today my INR is 5.9. My doctor suggests not taking my dose Sat. and Sunday, and resuming normal dose on Monday. It seems I will bottom out on that dose. I cannot get ahold the anti-coagulation clinic that normally helps me, until Monday. Any other suggestions would be most appreciated.

Thank you.

 

[TheGymGuy]

Use warfarin/coumadin calculator, it has helped me many many times - http://www.pace-med-apps.com/CoumCalc.htm
Retest in 4 days and use Calc again if you must.

 

[Lynlw]

I am the Thanksgiving person who over the holiday's managed to miss my warfarin 2 days in a row. I missed Sat. and Sun. and took a dose and half on Monday and Tuesday.

Today my INR is 5.9. My doctor suggests not taking my dose Sat. and Sunday, and resuming normal dose on Monday. It seems I will bottom out on that dose. I cannot get ahold the anti-coagulation clinic that normally helps me, until Monday. Any other suggestions would be most appreciated.

Thank you.

What were you taking before you missed your doses and were you usually in range then?

 

[Protimenow]

Personally, I wouldn't skip my dose for two days in a row. I MIGHT take a half dose one day, and a regular dose the next, but I've got a meter, and I can check to see the effects of these changes. PERHAPS a half dose today, full dose tomorrow, and half dose the day after may work -- but I'd be pretty cautious about doing something that will make my INR drop too quickly. (Actually, if my INR was STILL 5.9, I may skip a dose today, but resume normal dosing tomorrow).

Plus, with an INR that high, I'd be a bit more careful in my activities -- no skydiving for a day or two (not that I've ever done this).

Also -- with an INR that high, a blood draw is often performed to CONFIRM that this value is correct.

 

[Robbyn]

I take 7.0 mgs daily and yes my INR has been in range for at least 8 months.

This is my concern about not taking it for 2 days, that it will go too low. My INR has been high in the past and quite sure the anti-coagulations clinic has never instructed me to stop. It's unfortunate I can't remember what the dosing was.

 

[Bina]

I take 7.0 mgs daily and yes my INR has been in range for at least 8 months.

This is my concern about not taking it for 2 days, that it will go too low. My INR has been high in the past and quite sure the anti-coagulations clinic has never instructed me to stop. It's unfortunate I can't remember what the dosing was.

I'm late seeing this so probably can't help, but I wouldn't skip 2 days of doses for INR 5.9.........I would skip 1 day only and test again
in 4 days to make sure a change is taking effect.

 

[Robbyn]

Well Bina,

I thank you for that information, I did take the advice of taking a half dose yesterday, well a little less than half. Half would be 3.5 and I took 2. What do you think about for today, miss a dose? I will be able to talk to my anti-coagulation clinic tomorrow at Toronto General and they will advise me what to do.

I don't follow my GP's advise to skip 2 days, but at the same time don't always know what to do.

 

[Bina]

Well Bina,

I thank you for that information, I did take the advice of taking a half dose yesterday, well a little less than half. Half would be 3.5 and I took 2. What do you think about for today, miss a dose? I will be able to talk to my anti-coagulation clinic tomorrow at Toronto General and they will advise me what to do.

I don't follow my GP's advise to skip 2 days, but at the same time don't always know what to do.

So instead of taking your regular 7mg you took 2mg.
No need to skip dose for today, it is usually less risk to stay on the higher side of INR.
I would take 1/2 dose and re-test in about 4 days.

 

[Protimenow]

If you're really that concerned about it, you can eat some foods that are high in Vitamin K, or drink one of the drinks that are high in K (I think that I read that Boost is high in Vitamin K) or, if you're really concerned about it, get a Vitamin K supplement and take ONLY ONE. This will probably drop your INR, and won't require dropping your dosage of warfarin.

 

[Robbyn]

Thank everyone for your help. It got me through this warfarin mess. I called the anticoagulation and she told me I did everything right. And advised me what to do now.