inr low- again

[Megan]

just needing a little help on my inr levels- with aortic valve supposed to be between 2 and 3 but down to 1.8 and cant figure out why...i increased dose last night a smidge. would any of you bridge with lovenox at this level?
thanks
meg

 

[njean]

I know that if I reported a 1.8 INR to my cardio, he would insist I start on Lovenox. For this reason, I keep several syringes readily available if I have to bridge.

Have you called your cardio yet on your reading? Do you have Lovenox available?

I think rather than to guess of whether you should or shouldn't bridge, give your dr a quick call & see what he recommends.

 

[dick0236]

down to 1.8 and cant figure out
meg

If your recent INR's have been within range, a 1.8 may be bad test. I would recheck before making any adjustments. If you have been trending down at the low end of your 2-3 range, you may need to up your dosage. Al Lodwick's guide would recommend...INR<2.0 increase weekly dose by 10-15% and recheck in a week.

I can't help with the Lovenox question, as I have never had to use it. Of the few times I have been on the low side, I've always used increased dose to get back in range.

 

[olefin]

i increased dose last night a smidge. would any of you bridge with lovenox at this level?
thanks
meg

A smidge?

I have an AVR, my control is 2.5 to 3.5. Once in the last 18 years I tested 1.9. My cardiologist increased dosage by 15%. A week later, I was in control.
I know nothing about Lovenox.

 

[Ross]

If your recent INR's have been within range, a 1.8 may be bad test. I would recheck before making any adjustments. If you have been trending down at the low end of your 2-3 range, you may need to up your dosage. Al Lodwick's guide would recommend...INR<2.0 increase weekly dose by 10-15% and recheck in a week.

This is the answer in a nutshell without asking you your dose now and all that good stuff.

 

[Philip B]

Range

Range

At 1.8 you're only.2 out of range. Increasing your dosage, should bring you back up, but depending upon your metabolic rate, it will likely take two or three days before you see the change.

I've found myself at 1.8 a time or two. My perscribed range is 2.5 and 3.5. My cardio doc has told me on numerous occasions that he is comfortable that I've got an acceptable level of protection at 2.0. The 1.8's made me nervous, but I simply increased my dosage and got myself back up where I belonged. I typically increase my dosage when my tests indicate I'm on the low end of my range.

It would be nice to simply take a set dosage and maintain the same range number. Unfortunately, my metabolic rate fluctuates because it's difficult to get into a regular exercise routine due to my job schedule.

If you feel like this situation is beyond your control, it wouldn't be a bad thing to consult your cardiologist.

-Philip

 

[Megan]

thanks all. just to clarify, i normally take 10 mg on mondays so i took 12.5 mg instead. I retested yesterday because i was nervous and it was already 2.3 so it could have been a faulty #- hard to say. id like to retest today but know its prob not necessary..i just have this insatiable desire to know the # at all times still..i am going to get the rx for a few lovenox shots for just in case times to give me peace of mind. so if weekly dosage is 57.5, 10 % is 5.75- is that right? sorry i am NOT a math person at all. and your comments made me realize it could be lack of exercise this week. I had been going 3 times a week but with all the school half days and holidays havent been able to get to gym. so thanks!

 

[Bina]

Good thing that your INR is higher today....I've found that not letting it get below 2.5 is the safest and easiest for me. No worry, no fussing that way.
Yes, 10% of 57.5 is 5.75........you may be fine with an adjustment of 4 or 5 mg per week,
my adjustments have never been more than 5%, but that is me.

 

[Ross]

Just don't test too often. It takes 3 days for the full effect of a dose to show in a test, so testing more then 2 times a week is a waste.

 

[catwoman]

Megan:

You can test back to back and not get identical numbers. You might have gotten a 2.0 in the next test if you had run another one. Our blood is not 100% homogenized. That is, not unless you've been on some kind of carnival ride that jiggles you like a cocktail shaker............

 

[Cris N]

Megan:

You can test back to back and not get identical numbers. You might have gotten a 2.0 in the next test if you had run another one. Our blood is not 100% homogenized. That is, not unless you've been on some kind of carnival ride that jiggles you like a cocktail shaker............

Love the imagery