4.6! This is what I was afraid of!

[Mileena46]

My INR was 4.6! 3.8 last week! 3.4 the week before!

I am doing NOTHING different....no new meds...eating the same...taking the same dose of coumadin! I just don't understand why SUDDENLY it is going up and up and up. It has been staying in range for a couple of months and now I am wayyyy out!

I am pissed and scared because I don't know what to do! Doctor says skip tonight and take 5mg the rest of the weekend....come back in on Monday! SOoooo I am skipping a day and taking a 5 instead of 7.5 on Saturday! I don't believe that is going to lower it that much! I am also taking aspirin in the morning...I am thinking of not taking it too! Should I?

I am so upset!

Mileena

 

[Danny]

Sorry Mileena, i dont know anything about coumadin. But im sorry that your having these issues. Keep us posted.

 

[halleyg]

Hi Mileena,
The same thing happened to me earlier this year. I took 10 mg/day for over a year, then suddenly it started increasing for no reason. I couldn't understand it either and still don't know why it happened, but it does sometimes...now I take a lower weekly dose, and everything has been fine. I remember I was told a number of things could make it go up, or nothing (or at least nothing you can put your finger on). Don't be too freaked out, just work to get it in range and you'll be fine!
I'm not big on skipping an entire dose at any time, I personally would half it tonight, but that is me and based on my experiences. I'm sure one of the "pros" will come by shortly and be able to advise you on that! Just wanted to ease your mind about the high-with-no-reason aspect.

 

[ShezaGirlie]

Ah yes, same thing is happening to me these days. Week before last I was 3.6, last week I was 4.1 and this week 4.2. For 10 years I've taken 10mg and been really fine even though my INR bounces around like a ball without rhyme nor reason.

Frustrating = yep, if I'd let it get to me. I have a great coumadin nurse and we've decided to step down from the 10mg since I'm older now.., so I've been trying 8.5 on 4 days and 7.5 on 3 days a week to no avail. This week I'm down to 7.5 everyday, so we'll see what next Monday's reading will be. I never skip a dose...half it, but never skip it.

Some folks subscribe to the notion that exercise lowers your INR. Bullcorn, I say because I've exercised more in the last year than in my life and my INR is just going baloney.

You're allowed to be "pissed" but not "scared"..

 

[Ross]

I am pissed and scared because I don't know what to do! Doctor says skip tonight and take 5mg the rest of the weekend....come back in on Monday! SOoooo I am skipping a day and taking a 5 instead of 7.5 on Saturday! I don't believe that is going to lower it that much! I am also taking aspirin in the morning...I am thinking of not taking it too! Should I?

I am so upset!

Mileena

First of all, calm down. Your not going to blow up or anything like that.

No reason to be upset. 4.6 isn't a big deal. NEVER hold a dose for anything less then 5.0. Take a half dose, then lower your overall dose for the week by 10%. That's all.

What is your current normal weekly dose?

 

[Mileena46]

Currently taking 5mg 5 days and 7.5 on Tues and Sat....but I also take a full aspirin every day.

Thanks for the kind words you guys! I don't know if I am just upset in general and taking it out on the INR or what but I didn't sleep last night because of finding out about that young lady who passed away on here. It upset me more than I would have thought!

Mileena

 

[Freddie]

Mileena, I'm no expert, but here are my thoughts.
Your range should be 2.5 - 3.5 correct? Your really not that far out of range.

Since this scenario has also happened to me and I drop really fast when I skip a dose, may I suggest to cut your dosage in half for today - this way you'll have some medication in your system and working to bring you down slowly, and getting retested on Monday may show what you did today as far skipping or taking a half dose.

Take a half dose today and the 5mg that was suggested to you for the weekend. You may find your new "happy, medium" will be 6mg per day.

Getting scared is not worth it - it is what it is and so be it.

Now I may be totally off base with my suggestion,it's what I would do and if I'm wrong somebody will come and correct me.
Meanwhile don't fret.

 

[Ross]

Currently taking 5mg 5 days and 7.5 on Tues and Sat....but I also take a full aspirin every day.

Thanks for the kind words you guys! I don't know if I am just upset in general and taking it out on the INR or what but I didn't sleep last night because of finding out about that young lady who passed away on here. It upset me more than I would have thought!

Mileena

Hon I'm upset about the loss too. It kills me every time someone passes away from heart surgery because I have survivors guilt. I should not be here to help anyone, but I am.

Don't let INR rattle you. Well wait, if it's too low, then let it rattle you, but not to high..

For the time being, just take 5mg across the board for the week and test in one week.

 

[dick0236]

My INR was 4.6! 3.8 last week! 3.4 the week before!

Don't be upset. Your numbers are not bad and this is not a sudden change. Over the past few weeks you were showing a trend "up"(3.4 to 3.8 to 4.6) and a little change probably is warranted. Could be due to many reasons...diet, activity, etc. My guess is that if you go on 5mg every day, it might bring you down and keep you in range. This is why we test every few weeks. It's a learning process.

 

[Blanche]

Breathe in and breathe out...you are ok

Breathe in and breathe out...you are ok

Mileena:

My husband's INR range is 3.0 to 4.0 because of some complications. This has been his range since December 2000.

I can't tell you how many times his INR has been above INR=4.0. Recently, he registered an INR of 5.0 at 8am on our home monitor. We went to the doctor's office and tested on his monitor ( the doctor's office has the same monitor that we have.). The result from the doctor's office was 4.8. Later that day, we tested at home (I don't know why, but the doc asked us to.) His INR was then 4.2.

In the last 9 years, Al has had ups and downs with the INR. That is to be expected. It is the nature of the medication....and it is the medication that helps him keep on ticking. By the way, my guy had his valve replaced in October 1990, 19 years ago.


Hope all goes better for you.

Blanche

 

[ALCapshaw2]

First of all, calm down. Your not going to blow up or anything like that.

No reason to be upset. 4.6 isn't a big deal. NEVER hold a dose for anything less then 5.0. Take a half dose, then lower your overall dose for the week by 10%. That's all.

AMEN ! AMEN ! AMEN !

I NEVER Hold a Dose for an INR under 5.0,
just take 1/2 dose for ONE night and retest in 4-7 days.

Since your INR is/was rising, reducing your Weekly Dose by 10% is probably the wise thing to do. Since you were taking 40 mg/ week, that would come to 36 mg/week. Taking 5mg every day comes to 35/week which is pretty close. Do you have any 1 mg pills to 'tweek' with?

'AL C'

 

[Mileena46]

Hi Al,

No 1mg. The only dose I have ever taken is 5.

I did take a half dose last night because I wasn't comfortable with taking NO dose. I test again next Monday....so we will know then if this worked. I will also be missing my 7.5 on Sat, I will take a 5 then.

You guys are the best! I never ever come here upset without one or all of you saying SOMETHING that helps me to calm down. I will admit that last night I was really worried about my INR.

BTW I am also leaving off my morning aspirin!

Mileena

 

[ALCapshaw2]

Mileena -

I have some more questions...

Why are you taking Aspirin?

Why are you taking a Full 325mg Dose of Aspirin?
(Most Cardiologists recommend 81 mg (some recommend 162mg) for protection against Heart Attack and to minimize damage to the stomach).

Are you using Enteric (Coated) Aspirin to protect your stomach? (If Not, I STRONGLY recommend usind coated aspirin!)

FYI, Aspirin is an Anti-Platelet
Coumadin is an Anti-Coagulant

They work on two different components of the coagulation process to give better protection from clots forming in different parts of the circulation system. Some studies have shown that Low Dose (81mg) Aspirin gives almost as much protection as Full Dose (325mg) Aspirin with reduced side effects / risks.

'AL Capshaw'

 

[Ross]

I will admit that last night I was really worried about my INR.

BTW I am also leaving off my morning aspirin!

Mileena

NEVER get upset about your INR unless it's too low. Always remember, you can replace blood cells if you bleed, but you cannot replace brain cells if you stroke out.

Take your aspirin. It has nothing to do with INR.

 

[catwoman]

No 1mg. The only dose I have ever taken is 5.

Mileena:

Get your doctor to Rx you 1mg tablets. That will allow you to fine-tune your dosage much more exacting than with 5's.

I'm beginning to think too many doctors are Rxing just 5's and that's what we see/hear of a lot of INRs yo-yoing.
Warfarin is a sensitive drug -- that's why it comes in 1, 2, 2.5, 3, 4, 5, 6, 7.5 and 10mg tablets.

I keep 1s, 2s and 10s -- to split and create any dosage I might possibly need. Right now I'm taking 5.5X4 + 6.0X3. Those 1's sure come in handy.

 

[ALCapshaw2]

Mileena:

Get your doctor to Rx you 1mg tablets. That will allow you to fine-tune your dosage much more exacting than with 5's.

I'm beginning to think too many doctors are Rxing just 5's and that's what we see/hear of a lot of INRs yo-yoing.
Warfarin is a sensitive drug -- that's why it comes in 1, 2, 2.5, 3, 4, 5, 6, 7.5 and 10mg tablets.

I keep 1s, 2s and 10s -- to split and create any dosage I might possibly need. Right now I'm taking 5.5X4 + 6.0X3. Those 1's sure come in handy.

Marsha -

A lower cost way of achieving your 40mg/week would be to take 6mg X5 plus 5mg X2, thus taking only ONE tablet per day, minimizing cost, e.g. 6.5.6.6.6.5.6 on Sunday thru Saturday, without the need for pill splitting.

With 5's and 6's you can adjust anywhere from 35 mg/week to 42 mg/week in 1 mg steps simply by varying the daily allocation, all with only 1 tablet per day.

'AL C'

 

[netmiff]

my daily dosage is 9.5 mg, has been for mnths; I have 1, 2.5 and 5 mg pills, so each ight I take a 5, a 2.5 and two 2mgs. I don't care how many pills I have to take, I prefer to keep my dosage as even as posible, I'm just way too stupid to remember (even with a dosing box!) whether I should be taking 9 or 10 mgs that night!!

 

[catwoman]

Marsha -

A lower cost way of achieving your 40mg/week would be to take 6mg X5 plus 5mg X2, thus taking only ONE tablet per day, minimizing cost, e.g. 6.5.6.6.6.5.6 on Sunday thru Saturday, without the need for pill splitting.

With 5's and 6's you can adjust anywhere from 35 mg/week to 42 mg/week in 1 mg steps simply by varying the daily allocation, all with only 1 tablet per day.

'AL C'

Al:

A 90-tablet bottle of 10s and 1s each will stretch for 6 months (1s stretch a little longer). 90 tablets split = 180 days, 6 months roughly. (I'm no longer buying the 2mg tabs, but I have them on hand.) So, my Rx bill for the year for warfarin is $40 this way -- $20 each six months at Walmart.
Having the 1's gives me flexibility to create dosages as needed, and I don't mind splitting tablets. I do it all the time for my cats. (Those Zithromax tablets get chopped down to about 1/6 for cats; terbinafine gets split down to 1/8-1/4 250mg tablet.)
For folks who aren't used to splitting tablets, I'm sure they'd feel more comfortable having full tablets w/out need to split.

BTW, I read about pill splitting as a way to save on Rx costs from the AARP magazine. My PCP thinks it's great.

 

[Philip B]

Too High, Oh my Gawd!

Too High, Oh my Gawd!

Too high...the solution's easy...reduce your dosage and bring yourself back into range.

Metabolism can be a funky thing. That's why we check our INR on a regular basis and manage it by adjusting dosages. Relax...

-Philip