INR at 4.7 - help

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Taysgrama

Taysgrama

Well-known member
Joined
May 2, 2008
Messages
271
Location
Franklin, Ohio
Hi all - we are getting ready for our trip to AZ and NV and I tested a few minutes ago. My INR last Sunday (a week ago) was 4.0 and I really wasn't concerned, but I took it a few minutes ago and I am at 4.7. How do I dose? I usually take 2.5mg every day - no change unless I am below 2.5. I have been staying steady at 2.9-3.8 and my range is supposed to be 2.5-3.5 so really, 4.0 didn't bother me. Help Help Help...... Thanks again all!
 
Ross to the rescue! I am not good with this INR stuff! I am learning the hard way. I was at 4.5 about a month ago. She cut mine in half for two nights in a row. Not really sure she is so smart herself! It fell to 1.9 week later it was back at 3.1......... Going to get it checked tomorrow. Good Luck!
 
I hate it when the coumadin guru's are not on......I need to head to bed here shortly since we have to be at the airport at 5am tomorrow. Hopefully, one of them will be on shortly.

Good luck getting yourself back in range. I hate when I go out of range! If I do it too much my cardio is gonna make me go back to getting a blood test at the hospital.
 
Taysgrama said:
I hate it when the coumadin guru's are not on......I need to head to bed here shortly since we have to be at the airport at 5am tomorrow. Hopefully, one of them will be on shortly.

Good luck getting yourself back in range. I hate when I go out of range! If I do it too much my cardio is gonna make me go back to getting a blood test at the hospital.
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For the very reasonable price of $5 you can have your OWN PERSONAL Anti-Coagulation DOSING GUIDE available 24/7 from Al Lodwick, our own Anti-Coagulation Guru Extraordinair! (order from his website www.warfarinfo.com)

Here is his advice for an INR of 3.6 to 5.0 with a desired range of 2.5 to 3.5:

"Hold 1 dose (optionally). Decrease weekly dose by 10-15%. Recheck 2-4 weeks."

Personally, I don't like Holding a dose for anything under 5.0 so if it were ME, I would consider taking 1/2 dose for ONE night, then test in 4 to 7 days. If still high, I would reduce my weekly dose by 5% (small changes work well for ME). A 10% reduction would not be excessive.

'AL Capshaw' (I am NOT a medical professional)
 
OK - I did end up calling my doc since no one was on when I posted. He said to hold for 2 days and then restart on the third day. Test again in 4-5 days. I am just gonna hold for 1 day (today) and start my regular dose on Tuesday night. If anyone thinks I should really hold for 2 days, let me know. I will be on a plane for about 8 hours tomorrow and then I will check VR.com when I get to my son's house in the afternoon. He also asked me to only take 2.0 mg for a couple of days, but since my pills are 2.5mg I am not sure how to cut that to make it 2.0. Any ideas would be helpful.

In regards to the Coumadin dosing guide, I do plan on getting it, just been trying to save $$ for Vegas! LOL Anyway, I will post again tomorrow. Thanks all!!!
 
Nope nope nope - don't hold for 2 days!

With the low dose that you take, I'd hold for 1 day and test again sometime while you're on vacation. (Travel can kind of mess you up a bit - so take your machine just to be secure and not worry about what your INR is doing.)
 
I'm also a 2.5 mg/day person. A week ago Sunday I had a high 4.6. I held one day and kept on 2.5 daily . Test yesterday 3.3. So I am back on 2.5mgm/day this week and will test again next Sunday. I have only recently become unstable. I have had a chronic dry cough for weeks and some days feel like hell. Taking a lot of tylenol. I think the INR is somehow related to that and the infection I'm trying to fight off.My doctor thinks infection is due to mycoplasma.
 
My INR was 4.7 a couple weeks ago.:eek: The protime nurse told me to hold 2 days and return to my normal routine of 7.5 on M,W,F and 10 mg the rest of the days. I knew from the people on this fourm that to hold doses like that was wrong I would drop to fast and be way below my normal 2.5-3.5. I was told to half my doses for two days then went back to normal doses. The following week I tested 2.9 so felt much better about that. I have my own INR machine now so can keep better control. Most of the people on here know what their talking about. :)
Good luck on your decision.
Crystal :)
 
Taysgrama said:
OK - I did end up calling my doc since no one was on when I posted. He said to hold for 2 days and then restart on the third day. Test again in 4-5 days. I am just gonna hold for 1 day (today) and start my regular dose on Tuesday night. If anyone thinks I should really hold for 2 days, let me know. I will be on a plane for about 8 hours tomorrow and then I will check VR.com when I get to my son's house in the afternoon. He also asked me to only take 2.0 mg for a couple of days, but since my pills are 2.5mg I am not sure how to cut that to make it 2.0. Any ideas would be helpful.

In regards to the Coumadin dosing guide, I do plan on getting it, just been trying to save $$ for Vegas! LOL Anyway, I will post again tomorrow. Thanks all!!!
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Your doctor is INSANE. No problem, lets let the patient be at risk for a megastroke cause were stupid.

To take 2mg, your going to have to get a prescription for 2 mg tablets.
 
If you are dropping 1 dose and then resuming your original dose why not take 1/2 a dose for two days? The level will decrease and there will still be warfarin in your system.

I never hold a complete dose.

A two-day hold for 4.7 is too much.
 
With an INR of 4.7 holding for 2 days is just NUTS. Don't do it.
I would not hold even for one day.

My opinion is take a half dose tonight and test again in 3 or 4 days since you are travelling and things can change.
I have used very sharp scissors to cut pills, and I have a cheap pill cutter.
Have a nice trip. :)
 
I agree that holding your dose for 2 days is a mistake. That will probably drop your INR below 2. I also agree with ALCAPSHAW that you and everyone should buy the dosing algorithm.

Don't rely on just your doctor for adjustments in your dosing. They are often wrong.
 
azpam said:
I would have taken half dose for one day and have a fabulous spinach salad!
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Can't do the salad, but I will eat one of these:

popeyolivecan1.jpg
 
Woo Hoo - finally have gotten to a place where I have access to the internet and could read your responses....I did end up only holding one dose and doing my normal dose on Tuesday and then on out. I did bring my tester with me and will test on Friday morning. I will eat my greens this week too!!! And since I don't have time to go into the other threads and respond - ROSS - stop trying to be dentist too-next thing you know you will want to be a proctologist!!! LOL :D
 
I was recently at 4.6 and the nurse wanted me to skip for 1 day, then take a half dose the next day. I told her I wasn't that comfortable with that idea and said that I would much rather take a half dose two days in a row. Ultimately we went with what I wanted and the nurse saying something along the lines of you are just going to do what you want anyway and being angry that I would question her. There are four nurses in the Coumadin Clinic that I go to. One of which is really free and lets me do what I want which I like, two of the others seem to hate that I question their suggestions.
 
mattwisconsin said:
I was recently at 4.6 and the nurse wanted me to skip for 1 day, then take a half dose the next day. I told her I wasn't that comfortable with that idea and said that I would much rather take a half dose two days in a row. Ultimately we went with what I wanted and the nurse saying something along the lines of you are just going to do what you want anyway and being angry that I would question her. There are four nurses in the Coumadin Clinic that I go to. One of which is really free and lets me do what I want which I like, two of the others seem to hate that I question their suggestions.
Click to expand...

They hate it because if your right, it makes them look bad. If your wrong, it makes you look bad. All they need do is think it through if they have so much as an inkling of what they're doing and it should become clear as a bell.
 
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