Self-monitoring INR from the start

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Chuck C

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For all you nerds out there on Warfarin - have you read this? - Warfarin: The Definitive Guide — tl;dr pharmacy
Thanks Amy.
I note # 2 - wish that I was aware of this before going on amiodarone:

"Amiodarone (Cordarone/Nexterone) - This antiarrhythmic medication is even more infamous than sulfamethoxazole/trimethoprim for interacting with warfarin!"

" Consider a pre-emptive 30-50% reduction in warfarin dose with amiodarone initiation. "

This is good advice backed up by the literature. In three days my INR went from 3.1 to 9.7 after going on amiodarone. It had the effect of approximately doubling my warfarin dose.
 
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pellicle

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This is good advice backed up by the literature. In three days my INR went from 3.1 to 9.7 after going on amiodarone. It had the effect of approximately doubling my warfarin dose.
stuff that "jamms up the disposal hole in the bucket" is indeed an issue

Cytochrome P450 is important, so I'll just say Grapefruit juice and leave my first INR blog post sitting over here.
 
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Protimenow

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The only thing about buying used is there are blood products from previous user on machine. I went with new machine instead ,bought from wilbourn medical. It just showed up today. Payed 900 bucks for the kit. Insurance wanted to charge 3k to rent machine. Will see how it works out. I saw a used one just for machine was 180 bucks on eBay. I don’t need to get HepC or other virus like HIV, I have managed to avoid that working in medical field all of my life. YMMV
Not true. The meters don't actually draw blood products into the meter.

CoaguChek XS does an electronic test on the blood inside the strip - the strip doesn't come ANYWHERE NEAR the inside of the meter.

Coag-Sense may be a bit riskier - a wheel inside the strip turns - a clot makes the wheel stop turning. An optical sensor detects when the blood has clotted. But, again, no blood gets into the meter.

And - FWIW - even if blood products DO get into the meter (they don't), how is this putting you at ANY risk? You have no physical contact with what's inside the meter.
 

Protimenow

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Thanks Amy.
I note # 2 - wish that I was aware of this before going on amiodarone:

"Amiodarone (Cordarone/Nexterone) - This antiarrhythmic medication is even more infamous than sulfamethoxazole/trimethoprim for interacting with warfarin!"

" Consider a pre-emptive 30-50% reduction in warfarin dose with amiodarone initiation. "

This is good advice backed up by the literature. In three days my INR went from 3.1 to 9.7 after going on amiodarone. It had the effect of approximately doubling my warfarin dose.
And to think that, when I was having serious arrhythmias, my cardiologist started me on that NASTY STUFF (amiodarone).
 

Protimenow

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With only one exception, only one of my meters was acquired new.

And, FWIW, how do you know if a 'new' meter hasn't also been exposed to blood products? During manufacturing, quality control checks are probably made before the product is prepared for shipping. What do you think they use to do quality control tests?

Fear of blood products in the meters - ridiculous as it sounds - shouldn't be an issue for new, or old, meters.
 

Protimenow

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I didn’t see that a new machine was sold on eBay. I just know that the possibility of infection from a used machine maybe infinitesimally small to get an infection; but it’s not non-existent which is my entire point. If it’s new and cheap rock on , I missed out on it. Happy with what I got 50 test strips/controls/capillary tubes/coag sense meter/finger stick cartridges.
I see new Coag-Sense machines on eBay quite frequently. I would have ABSOLUTELY NO FEAR of a used Coag-Sense meter, as long as it comes with some kind of guarantee.
These things (Coag-Sense and CoaguChek XS) are made to do thousands of tests - they go into clinics and labs, so they HAVE to work , accurately, every time (and have QC tests that run before the strip is read). USED machines probably have very long lives left in them.
 

Chuck C

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And to think that, when I was having serious arrhythmias, my cardiologist started me on that NASTY STUFF (amiodarone).
It is indeed very nasty stuff. It wreaks havoc on your liver and drastically increases cancer rates for those on it long term. I'm very glad that I was only on it for one month, which does not correlate with long term damage or cancer risk.
 
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