Inr levels need you help

[tex]

Hi,
Just need some help here just got back from Anticoagulant Clinic, my INR level was 4.6 which is out of my range, 2.5-3.5 is in range, im not happy with the dosage they have put me on, its 10mg, 11mg 10mg, 11mg, etc for 2 weeks, when i went 2 weeks ago my INR was 2.9 and in 2 weeks it has gone up to 4.6. My dosage before today was 4- 10mgs and 3- 11mgs per week for
2 weeks, so in 2 weeks it rose from 2.9 to 4.6, all they have done today is knocked 1mg from my weekly dose i did say i didnt think this was enough as before now when it has gone this high they have made miss a day completely, i am just a bit worried i dont go back for 2 weeks and i feel if i carry on the dose they have told me to take i might be 6+ by the time i go, please can any of you advice me on my dosage for the next few weeks, at the clinic today i might of well just knocked my head against a brick wall, perhaps that might of not been a good idea LOL
Thanks for any help you can offer
Jane

 

[Karlynn]

So you went in and your INR was 2.9 and they changed your dose to 10/11/10/11 etc for 2 weeks - this is, essentially a weekly dose of 73.5. You had been on 61 mg/week with the 10/4 days and 11/3 days. So - if I'm calculating correctly - they raised your dose 20% for an in-range INR! No wonder you were high.

And that was my first question - why the heck did they change your dose for an in-range INR?

I'd go back to the original dose of 61/week. If you're more comfortable being around 3.5 - then you could try 10/3 days, 11/4 days. Just bump it a bit.

You are in the same dosage range that I am, and I find that just a few mgs/week tweak is all that I need most times.

Wait - cancel that, I reread our post - hang on - let me think this through again.

 

[Karlynn]

Okay - I'm confused - what dose gave you the 4.6 today. The way I read your post now - they increased your dose for a high INR - so I'm all confused.

 

[tex]

No they they kept my dosage from 2 weeks ago the same, i was 2.9, 2 weeks ago they kept me on 73mg weekly for 2 weeks but when i went back today it had gone up to 4.6 and the dosage they have put me on now is 72mg week. All they have cut me down by is 1mg, does this make sense?

 

[Bina]

Some of these clinic people can't do basic math?....
You were taking 73 mg per week, now you need to reduce by at least 5%.
If you now take 10 mg each day that would make 70 mg per week, which is a good start.
(the INR of 4.6 is not high enough for any drastic change)
Just my opinion.

 

[Bina]

Karlynn....you funny......drink your coffee.

 

[Karlynn]

Oops my math was bad - you were on 73/week (10/4 days + 11/3 days -gives you 73 ). If they have you alternating 10 and 11 for 2 weeks, that's 7 days of 10 and 7 days of 11, which totals 147, which means that it's 73.5/week - which is an increase of your dose by .5mg.

So I'm still confused.

Edit - changed numbers above - was typing 71 when my mind was saying 73 - Bina I don't drink coffee.

 

[geebee]

I agree with Bina - I would go to 10mg/day and retest in a week. The change they made of 1mg/week will not do much of anything.

 

[Karlynn]

Anyway - before I go back to bed and get out again to start my day over ------

I normally take 70/week. I've found that tweaking is best. If you went to 10/day (70/week) that would give you ~ a 4.25% decrease.

 

[Bina]

Karlynn, Jane was taking 73 mg/wk for the past 2 weeks.

 

[Bina]

okay, Let's tuck in Karlynn......nitey nite.

 

[tex]

Thats what i thought 1 mg wouldnt make any difference, i cant wait to get me home testing kit and sort with all your help of course my INR levels out.

 

[Karlynn]

Jane - please excuse my errors - boy - am I off today!!!!!!!

And if they did truly tell you today to alternate 10 and 11 for 2 weeks - they were, in essence, keeping your dose the same, forgiving the .5. So maybe someone at the clinic is as bad at math as I am.

Yup - I'd do 10/day for a week and retest.

 

[Karlynn]

And...... If your INR is back in range - test again in a week after that to keep an eye on it. I wouldn't wait 2 weeks.

Just an example. 3 weeks ago my INR was 2.5. I didn't do a thing to my dose. Tested in a week - it was 4.5. I halved 1 night's dose and resumed my usual dose. Yesterday it was 3.5.

I don't really try to figure out why, cuz sometimes there is just no good reason.

 

[Freddie]

Karlynn must have put something stronger in her coffee......she's on a roll now

Tex, I think what is trying to be said here (I haven't had my coffee yet ) is that when ever you have a dosage change test in one week (7 days apart)

Boy how can you tell its Monday morning

 

[Bina]

Yup, It's a Monday morning thing.....I'll confess that my first mental calculation didn't make much sense, so I got out my pencil and paper.

 

[tex]

Lol, you lot on here on great you do make me laugh, well had 10mg last night and i will carry on with that for a week, just phoned to make an appointment for next monday to be re-tested but its a bank holiday so they are closed i am going Wednesday, i will carry on taking 10mgs till i go back does this sound ok? I think i am just getting my head round how to dose but still a little unsure, when it went to 4.9 last time which was a few months ago i saw another doctor who reduced my dosage to 10mg for 6 days and i had a day off completly without taking any, its just amazing that it changes so much depending on which doctor you see.
I did say yesterday about what the other doctor had done when it went up and her answer was well that was him, im doing dosing this way, what do you say to that?
Thanks again for all your help i knew i could count on you lot.
Take care
Jane

 

[Bridgette]

Say to her, "When I get my home tester (and Al Lodwick's dosing chart) I'll be doing it MY way!" LOL, and see what she says to that.....

 

[sue943]

I would avoid that particular doctor in future. We have a warfarin clinic in our hospital phlebotomy department, they seem to be very good, then I get my prescriptions from my GP.