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halleyg

halleyg

VR.org Supporter
Supporting Member
Joined
Jul 19, 2007
Messages
591
Location
Atlanta, GA
Two Fridays ago my INR was 1.8. Started taking 9 mg/day and retested this past Friday; however, I started going to a lab since it's closer to my house, and the results won't be back until Wed. at the latest. In the meantime, I had strep throat and started taking amoxicillan yesterday. I was just reading in another post that it raises INR... so should I decrease my dosage or just keep going with 9 since it was so low? Needs to be 2.5 to 3.5.

Also wanted to add that I wasn't taking amox. at time of testing, so should I retest sooner...
 
I can't help you with the dosage, but wanted to say it is unacceptable to not get your INR results the same day, let alone 5 days later. I would call and raise heck Monday, 5 day old results are pretty much useless.
 
It's imperative to have the test results the same day otherwise the test is no good. Amoxicillin shouldn't affect your INR. It never has mine.
 
Ugh, I had no idea... I feel like I am walking through all of this blindly. Guess I'll trek back out to my dr. office on Monday to get the finger stick - the lab took the blood from my arm. I really like my dr. but feel like she isn't helping me enough in this area.

Should I continue taking 9 since I'm on the antibiotic or just get tested tomorrow and wait and see?
 
For some reason I wasn't able to edit my post, but Ross, I read yours again about INR not changing from the antibiotics. Guess I'll just stick to what I'm doing and get tested tomorrow.
 
halleyg said:
For some reason I wasn't able to edit my post, but Ross, I read yours again about INR not changing from the antibiotics. Guess I'll just stick to what I'm doing and get tested tomorrow.
Click to expand...
Yes but make certain you get the results before you leave. There is no way to make any adjustments without a "Right Now" picture of your INR.
 
I suspect that a One Day Dose of Amoxicillin (or other) antibiotic for Dental work won't make much difference, BUT, taking any antibiotic for 7 or more days for an infection is Very Likely to have an effect on INR and should be Monitored, probably every 4 days.

'AL Capshaw'
 
Thanks, Al. I am supposed to take the amox. for 10 days, so I guess that will affect me. I am thinking of changing drs. since mine doesn't seem very proactive in monitoring my INR, plus the drive is too inconvenient for weekly visitis. The dr. I am seeing is an internist. I was wondering what type of dr. most of you go to for monitoring, and internist or cardiologist? How do you know if they know what they are doing when it comes to this stuff? I really like my dr. for everything else (although luckily this is the only big thing I've had) so I hate to change but I don't feel comfortable with all this.

edit: I was also wondering if I should not take my 9 mg dose tonight. Should I take less. I started reading about how antibiotics can raise INR and now I am really worried. I tend to panic about stuff like this.
 
You are in Atlanta. There should be a coumadin clinic close to you.You may want to ask you internist. I kept my same doctors, cardiologist and Primary Care, when I was on coumadin last year. The INR was managed by a coumadin clinic. That is all they do is coumadin management. They were good for the most part.
 
Cardiologist usually monitors you. Hon I'd stay at 9 until you test again. I don't think your going to see a difference. If you were taking a mycin or some of the other antibiotics, you could expect a huge increase in a short amount of time. I haven't seen it happen with Amoxicillin.
 
Do a SEARCH for "Coumadin Clinic" (either on VR.com or Google etc.)

Properly trained Nurses (especially CRNP's) do a VERY GOOD Job of managing their patients, and they see a LOT of patients. My Coumadin Clinic averages over 140 INR's per DAY with 4 CRNP's who seem to "know their stuff".

People with complex health issues are wise to use an INTERNIST for their Primary Care Physician.

Individual physicians are NOT known for doing a good job of managing INR. (Too mundane, not up to date on the latest protocols, too few patients to develop a broad based understanding, etc. etc.)

It will be interesting to see IF / How your Amoxicillin affects your INR. Please let us all know so that the rest of us can learn from your experience.

'AL Capshaw'
 
You can check out www.acforum.org for a listing of coumadin clinics; it isn't all that up to date on the locations, but it's a start. There are some locations mentioned in Atlanta, although the one I go to in Michigan still isn't listed.
 
JimL said:
You can check out www.acforum.org for a listing of coumadin clinics; it isn't all that up to date on the locations, but it's a start. There are some locations mentioned in Atlanta, although the one I go to in Michigan still isn't listed.
Click to expand...
Hey people, if you find clinics not listed, please let them know so they can check and add as necessary. It would benefit all of us.

http://www.acforum.org/contact.html
 
halleyg said:
Two Fridays ago my INR was 1.8. Started taking 9 mg/day and retested this past Friday; however, I started going to a lab since it's closer to my house, and the results won't be back until Wed. at the latest.
...
Click to expand...

Halley,

I agree with Ross, a 5 DAY wait for INR results is UNACCEPTABLE. It makes me wonder where your Doc is sending the Blood for analysis, and How Long is Sits Around before being analyzed.

I hope you can find a Dedicated Coumadin Clinic in your area, preferably one that uses the Finger Stick Testers that can give you the INR reading while you are there.

'AL Capshaw'
 
Update on my INR

Update on my INR

First off, wanted to clarify that my dr. does do the finger stick test for immediate results. I was getting tired of driving out there every week so I inquired and was told (by dr. staff) I could go to a lab near the hospital where I do rehab. The lab is the one (last Friday) who told me to wait until Wed., although when I spoke to someone at the dr. office today, she said she told me I couldn't get same-day results, which I do not recall her saying. Plus I don't know why the dr. would approve that, but she wasn't in the office when I went today. Took my 9 mg last night as usual and today tested at 2.4 - still too low. Nurse was communicating w/my dr. by email since she was at another office. Told dr. I was taking 9, told her I was on amoxicillan, and dr. still said to continue taking 9 and come back in 7-10 days. I told her that I was told I needed to test more frequently while on the antibiotics and I don't see why she isn't increasing the dose if I haven't been at the desired level in two months now. She emailed her back and she said I could come back on Friday but nothing about increasing my dose. Nurse said maybe since I am on the antibiotic. Anyhow, I feel better having my results but I am going to call the coumadin clinic near me - I can't believe I didn't know about these! I don't know what I'd do without the advice I get here. Thanks, all :)
 
2.4 isn't that far off. Perhaps another test will show in range, but it will be just in range if at all. It's your choice, if it were me, I'd bump my overall weekly dose up by 10% and wait for that next test. So if your taking 9x7=63 add another 5 or 6 mg and see what the next test holds. What mg pills do you have to work with?
 
I just got off the phone with the coumadin clinic and the nurse was so helpful. She told me just for today to bump my dose up to 12.5, then I am going in Wed. for testing. She said she wants to make sure the amoxicillan isn't messing with my blood. She likes to test on day three of antibiotics (which is today for me). I feel so much better after speaking to someone who knew what she was talking about - kind of like when I come here :) .
 
But watch how she doses you. Bumping it to 12.5 is usually a sign they're rushing you into range or beyond. That 12.5 you take today, won't show up until Thursday, so you'll test before it maxs out, which places you artificially into range or just above. Then I bet they want to lower it again. If so, they causing your problem. Not trying to worry you further, let's just see what they do. Maybe they'll surprise me.
 
I likes that the nurse wants to test 3 days after starting an antibiotic. (I'm assuming that if Halley didn't already have her INR she also would have had her test before starting to take it.)

Like Ross - not so sure about the 12.5 - but we'll see. You will learn soon how your body reacts to dosage changes. Make sure you are keeping your own chart or graph on your INR.
 
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