- Sep 22, 2015
- Tallahassee, Florida
Last Sunday I decided to skip two doses of Warfarin to see how fast my INR dropped and how fast I could get it back up to therapeutic range (as a test in anticipation of non-cardiac surgery). My range is 2.5-3.5 (mitral valve) and I have historically been stable in that range with a daily Warfarin dosage of 7.5 mg. So, starting with an INR of 3.2 last Sunday I skipped my Sunday night and Monday night doses. On Tuesday night my INR was 1.6, a quicker drop than I had anticipated. That night I resumed Warfarin with 10 mg and on Wednesday night I took 12.5 mg, knowing well that by then my INR was probably getting close to 1. On Thursday night I took 15 mg and on Friday and Saturday nights I took my normal 7.5 mg. For the 5-day week I took 52.5 mg which is the same weekly dose as when I take 7.5 mg a day for seven days. Well, low and behold, my INR on Sunday was back up to 3.6 with no muss, no fuss. The upshot for me is that for minor surgeries that recommend an INR below 2, this would be a safe way to accomplish it without bridging or risk of bleeding. The risk of thrombosis is also low, especially since my INR drops quickly and rises quickly as well, leaving only a few days at most below therapeutic range. And if blood clots on a valve take upwards of a week to form, as I have read on this site as well as others, what's not to like?