Inr

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Paul1972

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Cheers Pellicle and Warwick thanks for all the information guys I appreciate it 👍 Hope you are all well 😊
 

Paul1972

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Hi
what was your previous dose history (at least for say the last week or (prefereably at least) two, just something like "Xmg per day, INR =Y is enough).

I'm tempted in the absence of knowledge to say "drop 50% of your dose on your next dose time and then resume on the previous".

let me know if you want better than that
Hi Pellicle my previous doses for the last two weeks has been 8.5mg and my previous three inr have been 3.0, 3.2 , and then 4.9 because I’ve been on holiday for week with change of diet and consuming alcohol 😊
 

Warrick

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Yep alcohol puts mine up like that too..

Whereas my father (mechanical as well) use to get paralytic when I was a kid and it never affected his INR
 

Paul1972

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Yep alcohol puts mine up like that too..

Whereas my father (mechanical as well) use to get paralytic when I was a kid and it never affected his INR
It’s weird how things effect us in different ways Warrick isn’t it 😊
 

leadville

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I drink very little now as it makes this thumping/ Ticking in my throat difficult to sleep, it increases my heart rate, but in the past when i have used alcohol it sends my INR upwards.

we are all different i suppose
 

Paul1972

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That’s just how it makes me feel Leadville,also makes it a bit fluttery at night. I only have a couple at weekends.On holidays I tend to have a few more 😊
 

pellicle

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my previous doses for the last two weeks has been 8.5mg and my previous three inr have been 3.0, 3.2 , and then 4.9 because I’ve been on holiday for week with change of diet and consuming alcohol 😊
so I'd put your metabolism similar to @Warrick and so your response to changes in dose reflected in INR will be closer to his than mine so you may see it a day faster than me. Either way I think the change in the dose you made and then resumption on your regular will see you return to "normal"

I'll be interested to know what comes
 

pellicle

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I drink very little now as it makes this thumping/ Ticking in my throat difficult to sleep,
I experienced similar for the first few years ... no more than a glass of red. But in the last few years I've been able to have a bit more (like a glass of red after a beer and a burbon to follow) ... but if I let BAC go higher then its (as you say) difficult to sleep. I've found (by experimentation) that different alcohols cause a different response ... so I've gone where the results are ;-)
 

Protimenow

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It's interesting that 'different alcohols cause a different response.' I'd attribute the different responses to the stuff that's in there, besides alcohol, that produces the responses. It's what makes Gin, for example, taste different from Bourbon. When the 'alcohol' is distilled, the result isn't just Ethyl Alcohol - which, I think, is pretty tasteless (and which is added to our gasoline, here in the United States) - it's also partially what gives each drink its own flavor. Aging in wood adds flavor to many drinks, in the case of Gin, they add Juniper berries, and other liquors and liqueurs have other additives.

I suspect that different 'liquors' may have different effects on INR, and that this may vary from person to person.

Here, again, it's great to have your own meter and do self-testing to determine short-term effects. And, of course, if you regulate your dose of INR to match the effects of drinking a particular 'sauce' or group of 'sauces', you may want to consistently drink that stuff in order to regulate your INR.
 

LoveMyBraveHeart

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Curious, as I begin to start ACT on Mathias, when you take partial doses, are you splitting the pills in half, quarters, etc? Someone suggested lowering by one mg, not sure how to split a 5mg tab into 5 pieces. Or over the years have you acquired different dose tablets so you can make what dose you need? Sorry if this is a silly question...as we venture down this path, I want to have as much info as possible so we don't have to call in and wait for a reply every time a blood test comes back less (or more) than satisfactory.
 

leadville

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its a great question, there are no silly ones

Warfarin comes in 1mg, 3mg and 5 mg pills ( from my Chemist )
i believe there are also different strengths.

its easier to take half mg by splitting the 1mg pill ( i never have used 0.5 )

it could get messy & inaccurate if you only have 5mg pills

I ask my doctor for 3mg and 1mg i find it easier to dose ( currently 15mg per day )

But if i alter my dose it's easy if you have different strengths, this combination seems to cover most dose scenarios for me

hope that helps
 
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Protimenow

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This isn't a silly question at all.

Warfarin is available in a variety of useful doses. The doses seem to have been designed so that they CAN be cut in half.

Personally, I get 1 mg, 4 mg (which can be cut into 2 mg halves), 5 mg and 7.5 mg. You can also get 2.5 and 10 mg pills.

For quite a while, I was taking 7.5 mg daily. I dropped it to 7 mg, which I created with one 4 mg pill, a half of a 4 mg pill, and a 1 mg pill. I've just simplified this slightly by using a 5 mg pill plus a half of a 4 mg pill. You shouldn't worry about half pills not being 'exact' - they're close enough. (For example, I don't worry that if I split a 4 mg pill in half, one would be 1.95 mg and the other would be 2.05 mg, assuming that I didn't lose any when I cracked the pill).

If you DO split pills, do them over a surface -- years ago, I split some pills, and one of my dogs somehow got the 'dust' residue from the split pills into her system - maybe she picked it up on her feet and licked her feet, but for a while it seemed like she briefly had some blood in her uring (and this could have been something other than a high INR). For me, even though I unfortunately have no dogs, I split the pills over a table, just to be safe.

Your doctor may balk at prescribing a range of doses, but once you explain that you'll be able to get the right dose for Mathias by splitting pills if necessary. (Also, try to establish the right dose - not by switching doses frequently - and change the dose slowly and only when it seems necessary to get back in range.)
 

LoveMyBraveHeart

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This isn't a silly question at all.

Warfarin is available in a variety of useful doses. The doses seem to have been designed so that they CAN be cut in half.

Personally, I get 1 mg, 4 mg (which can be cut into 2 mg halves), 5 mg and 7.5 mg. You can also get 2.5 and 10 mg pills.

For quite a while, I was taking 7.5 mg daily. I dropped it to 7 mg, which I created with one 4 mg pill, a half of a 4 mg pill, and a 1 mg pill. I've just simplified this slightly by using a 5 mg pill plus a half of a 4 mg pill. You shouldn't worry about half pills not being 'exact' - they're close enough. (For example, I don't worry that if I split a 4 mg pill in half, one would be 1.95 mg and the other would be 2.05 mg, assuming that I didn't lose any when I cracked the pill).

If you DO split pills, do them over a surface -- years ago, I split some pills, and one of my dogs somehow got the 'dust' residue from the split pills into her system - maybe she picked it up on her feet and licked her feet, but for a while it seemed like she briefly had some blood in her uring (and this could have been something other than a high INR). For me, even though I unfortunately have no dogs, I split the pills over a table, just to be safe.

Your doctor may balk at prescribing a range of doses, but once you explain that you'll be able to get the right dose for Mathias by splitting pills if necessary. (Also, try to establish the right dose - not by switching doses frequently - and change the dose slowly and only when it seems necessary to get back in range.)
Once we get a "base" dose for where they want his INR to be, I will ask for a range of tablet concentrations. I'm sure they will look at me like I have two heads as why in the world would I question their expertise and not just call with an INR and wait for an updated dose, but I will try to stand my ground. Maybe I can ask for 4 mg and 1 mg to start...those concentrations seem like they will be fairly versatile.

Thank you for the prompt answer. I know we aren't even close to being at a regulated INR yet, but I don't like to rely on doctors for the best course of action all the time...books only teach so much and often things are missed or miscommunicated and I want to avoid any trouble as much as possible. We go to the hematologist tomorrow.
 

pellicle

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Hi

to answer your earlier question you do split them. I strongly recommend you book mark my blog post here as its a very lengthy summary reference of almost everything you could ask:


please, don't use a phone to view it in any other way than thinking about viewing anything on something the size of a pocket notebook (such as a shopping list) ... a real computer will show it better and make it easier to read (iPads are not real computers IMO, so laptops or desktops)

There are two major brands of "warfarin" one is Coumadin and the other Marevan (then there are the various low price generics. I strongly urge you to stick to one brand) ...

On that blog post you'll find this diagram:


which shows you not only the sizes but also a splitting line.
Myself I use Marevan which has less pill sizes: 1, 3 and 5. By splitting them and or combining them I get pretty much exactly the dose I want / need.

Once we get a "base" dose for where they want his INR to be
bear in mind that that does will change in the months after surgery, this is well documented. So you may start at (say) 4mg and gradually wind your way up to 7.5 (or something similar).


.... Maybe I can ask for 4 mg and 1 mg to start...those concentrations seem like they will be fairly versatile.
I'd agree, but myself I keep 1 3 and 5 on hand as my dose is 7.5mg (although if you read and look at my graphs carefully with an eye of a middle school student you'll see that my dose does move around)

I'm sure that there is enough data there to help you onw your way. Don't skim it like a social media post but read it carefully like you were actually going to need that data. Like we used to teach kids in school to do. Naturally the only exam is life and I'm of course open to questions and requests of help. Reach out if you have any of those.

Best Wishes
 

LoveMyBraveHeart

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I'm sure that there is enough data there to help you onw your way. Don't skim it like a social media post but read it carefully like you were actually going to need that data. Like we used to teach kids in school to do. Naturally the only exam is life and I'm of course open to questions and requests of help. Reach out if you have any of those.

Best Wishes
Wow! thank you. I just printed the blog post. I'm hoping I can find an app or something that will help track data...I'm not very technologically savvy. I will keep this printed post for future reference (along with all my other printed notes of research :geek:)
 

pellicle

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It's interesting that 'different alcohols cause a different response.' I'd attribute the different responses to the stuff that's in there,
absolutely it must be "what's in there".

Anecdotally if you work in Bars in Australia you'll find that more fights start with Rum than Scotch Whiskey (and not just because of consumed volume) it is / was known as "Dutch Courage" in the British Empire for some centuries.

So I find that aside from the pure alcohol response there are others. I always encourage good scientific exploration (in moderation) of this.
 

dick0236

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Once we get a "base" dose for where they want his INR to be, I will ask for a range of tablet concentrations.
The more different doses of warfarin you keep on hand means the greater the chance to grab the wrong pill. I keep 1mg and 5mg on hand. Mine are Tara brand and are scored to easily break evenly. These two tablets allow me to take virtually any strength from .5mg to 10mg. I try to keep my life as uncomplicated as possible :p.
 

pellicle

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Hi
Wow! thank you.
you're welcome ... its public after all ;-)

I'm hoping I can find an app or something that will help track data...I'm not very technologically savvy.
myself I totally despise most apps (and I'm a software developer) for these reasons (link) and the situation has only become worse since 2012 when I wrote that. So my most sincere advice is "use a spread sheet" and store that on your computer AND also on a cloud storage.

I use a spread sheet for my INR tracking and if you wish I am happy to asssist you to set one up. Sure a piece of paper works but I am certain that you'll find (for instance) graphing stuff is critical to understanding what's happening and making decisions, and no piece of paper does that without you making a lot of effort. I use Excel but you can also use Open Office (now called Libre Office) across platforms (Mac, PC, Unix) and its free.

Best Wishes
 
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