I think the thing about being unable to accurately quarter a warfarin pill is a bit of FUD (fear, uncertainty, doubt) that one of the pill manufacturers told the physicians to prescribe the medication. Years ago, they created a fear of generic warfarin, saying that the dosages were inaccurate, the effects were different from those for patented coumadin, etc. The use of a meter or blood draw to validate INRs after changing from coumadin to warfarin shattered that myth (but it's still not a bad idea to confirm the effect when switching providers).
For a fast acting medication that may have serious effects if you underdose or overdose, the argument that you can't accurately split a pill a second time may have validity, but for something like warfarin, where the effects are slow to be seen, and where the INR values fluctuate through the day, and where tenths of a milligram don't have extreme impact, I don't have a big problem with trying to accurately split a half a pill a second time. For example -- I take 7 mg/day -- and I get this by splitting a 10 mg and a 4 mg and taking half of each. Should it appear that I need 7.5 mg a day, what I would probably do is split a 10, take 1/2 of the ten, and then split the other half to ROUGHLY 2.5 mg. The next day, I'll take the other 'quarter' pill and a half of a new 10 mg. The ultimate total for two days would still be 15 mg, even if one day, I'm taking 7.3 and the other day it's 7.7.
I really don't see a big problem with attempting to break a warfarin pill into quarters. (I make my own 81mg aspirin by quartering a 325 mg - sure, none of the quarters are exactly the same, but the overall effect is slow and cumulative, so I don't have a big problem with doing it this way).
Oh -- on the subject of cutting 'crumbs' -- I don't think that you'd be throwing away too much dosage even if you toss the crumbs. If a 1/4 cut gives you a solid piece of pill and a bunch of little crumbs, you probably throw them away and cut another 'quarter.'
Still -- it wouldn't hurt to have a supply of 1 mg, 2.5 mg, and 10 mg pills on hand so you can pretty much create any dosage needed by combining whole or half pills. (Actually, the 2.5 may not be necessary, but it makes things easier if you want a 2.5, 5, or 7.5).
I'm hoping that if you're a chronic warfarin user (and I seem to recall that in your case this may not be the case), you'll be able to get a meter and self-test.
For a fast acting medication that may have serious effects if you underdose or overdose, the argument that you can't accurately split a pill a second time may have validity, but for something like warfarin, where the effects are slow to be seen, and where the INR values fluctuate through the day, and where tenths of a milligram don't have extreme impact, I don't have a big problem with trying to accurately split a half a pill a second time. For example -- I take 7 mg/day -- and I get this by splitting a 10 mg and a 4 mg and taking half of each. Should it appear that I need 7.5 mg a day, what I would probably do is split a 10, take 1/2 of the ten, and then split the other half to ROUGHLY 2.5 mg. The next day, I'll take the other 'quarter' pill and a half of a new 10 mg. The ultimate total for two days would still be 15 mg, even if one day, I'm taking 7.3 and the other day it's 7.7.
I really don't see a big problem with attempting to break a warfarin pill into quarters. (I make my own 81mg aspirin by quartering a 325 mg - sure, none of the quarters are exactly the same, but the overall effect is slow and cumulative, so I don't have a big problem with doing it this way).
Oh -- on the subject of cutting 'crumbs' -- I don't think that you'd be throwing away too much dosage even if you toss the crumbs. If a 1/4 cut gives you a solid piece of pill and a bunch of little crumbs, you probably throw them away and cut another 'quarter.'
Still -- it wouldn't hurt to have a supply of 1 mg, 2.5 mg, and 10 mg pills on hand so you can pretty much create any dosage needed by combining whole or half pills. (Actually, the 2.5 may not be necessary, but it makes things easier if you want a 2.5, 5, or 7.5).
I'm hoping that if you're a chronic warfarin user (and I seem to recall that in your case this may not be the case), you'll be able to get a meter and self-test.
