Advice Please

[Robbyn]

Because of the Thanksgiving weekend, and all the activities around my house, I seem to have managed to miss taking my Coumadin not only once, but two days in a row. I know how to dose for missing one day, but not two. Can anyone advise me what to take. Thank you.

 

[AgilityDog]

Split the one missed dose between 2 days. Probably ignore the second missed dose 'cause you don't want to over correct by taking too much in too short a time period. Big "loading doses" are NOT advised.
If you can home test, do so. If you are below 2, you may want to take a day or 2 of lovenox shots (If you don't have an RX, call your doctor ASAP).

So if you take 4 mg daily, but missed 2 days, you should take 6mg 1 day, 6 mg the next day, then back to 4 mg. Test after about 4 days.
After 3-4 days with this correction, you should be at or near your range.

 

[dick0236]

Split the one missed dose between 2 days. Probably ignore the second missed dose 'cause you don't want to over correct by taking too much in too short a time period. Big "loading doses" are NOT advised.
If you can home test, do so. If you are below 2, you may want to take a day or 2 of lovenox shots (If you don't have an RX, call your doctor ASAP).

So if you take 4 mg daily, but missed 2 days, you should take 6mg 1 day, 6 mg the next day, then back to 4 mg. Test after about 4 days.
After 3-4 days with this correction, you should be at or near your range.

This is what I'd do.....and be sure to test after about 4 days.

 

[JimL]

My first thought is to figure out your dosing on a weekly schedule, and divide up the missed doses over the next few days to a week, so that over the long term you have the correct amount. Whatever you decide, relax, INR stands for It's Never Right, anyway.

 

[Protimenow]

The Duke Clinic protocol calls for increasing the dosage to 1.5X normal the first day IF YOUR INR IS BELOW 2.0. Even missing two daily doses may not drop you that low -- and, according to studies that I've seen (including something in the Duke protocol), being below 2.0 for a few days isn't a major risk if you're more than 3 months post-op. If it was me (and I have HAD a TIA (that doctors called a Stroke) because I was under 2.0 for probably a week or more), I would take 1.5 times my usual dose on the day that I realized I missed for two days, and then go back to normal. I have a meter, so I'd be checking to see how low my INR may have gotten - and how quickly it rebounded.

I don't think there would be ANY need for Lovenox with an INR drop for just a few days.

 

[Bina]

Naughty girl..........I would also take an extra half dose only once.......and TEST !!

 

[Robbyn]

Thanks everyone for the info. Never missed 2 days before. I split one day dose in half over two days and will check on Thursday. I will find out that evening what it is, so it should be good.