Another question to all you experts

[vboesen]

How long did it take most of you to get on a regular dose of Warfarin? I mean without it changing. We are now 4 days 3 mg and three days 2 mg. Who knows after we get our next blood work, what it will be......

Thanks to all!

Valerie

 

[geebee]

Valerie,

It's been so long I am not sure I really remember but I think it was about 2 months of zeroing in on the correct dose. After that, I have been on pretty much the same dose for 25 years.

 

[Ross]

It really depends on your recovery, since during that period, your INR is all over the place. Once your physically stable, eating a consistent diet, off most medications, that's when it starts to settle. For me, it took about 2 months also. Most happen in 1. The other key factor in determining is, does the person doing your management understand what they are doing? If the answer is no, you'll never get straightened out.

You say your doing 3mg four days a week and 2mg three days a week. How is this being taken? Alternating days I would hope? Also, how often are they testing you? If it's more then twice a week and making changes each time, it's time to go find someone that knows what they are doing. What was your INR at your last test and how soon did they tell you the number?

 

[Guest]

Even when you find the correct dose it is common to needs small tweaks up and down over time.

 

[catwoman]

I've been on 6.5 for 1+ years, maybe 18MO. Sometimes a little less, sometimes a little more, depending on whether I'm taking other Rxes.
I think it was 3-4MO before I was fairly stable on my INR.

Home-testing and adjusting my own dosage sure makes my life easier!

 

[vboesen]

Hello Ross,

Initially we tried alternating days but that didn't work so now it is 4 straight days of 3 and 3 straight days of 2. She is being tested every 2 weeks. Her INR was tested last Thursday and we found out that evening it was 1.8.

I have a perscription for a home monitoring sytem but not sure where to turn to get it and is it covered under durable medical equipment? That would make life easier. I would feel comfortable having my husband dose her because he is a Pediatric cardiac ICU RN and has been for 20 + years.

Look forward to your response.

Valerie

It really depends on your recovery, since during that period, your INR is all over the place. Once your physically stable, eating a consistent diet, off most medications, that's when it starts to settle. For me, it took about 2 months also. Most happen in 1. The other key factor in determining is, does the person doing your management understand what they are doing? If the answer is no, you'll never get straightened out.

You say your doing 3mg four days a week and 2mg three days a week. How is this being taken? Alternating days I would hope? Also, how often are they testing you? If it's more then twice a week and making changes each time, it's time to go find someone that knows what they are doing. What was your INR at your last test and how soon did they tell you the number?

 

[Ross]

I personally think it's best to alternate days so that a more even consistent amount of the drug is in the system. On that low of a dose, it may not make much difference, but alternating would be more effective in my opinion. I'm no Doc, so feel free to discard that statement if you wish.

So we have 4 x 3=12 and 3 x 2=6 so 12+6=18mg for the week. 18/7=3 and she's only 1.8. What we would normally do is increase that dose. This may be too high, but I have a gut feeling into put you in the window 3.5 four days a week and 3 for three days a week. Alternate it of course. This will push from 18mg over the week to 23mg. retest in one week.

As for the presciption, I'm sure QAS would be glad to help you out. You pretty much let them deal with your insurance company and save yourself frustrations. You can download all the forms you need for whichever machine you choose from the links below:

http://www.protimetest.com/downloads.asp

http://www.ptinratio.com/patient_how_to_get.asp

 

[catwoman]

I have a perscription for a home monitoring sytem but not sure where to turn to get it and is it covered under durable medical equipment? That would make life easier. I would feel comfortable having my husband dose her because he is a Pediatric cardiac ICU RN and has been for 20 + years.

Valerie:

Al Lodwick has a website -- www.warfarinfo.com -- where you can order an algorithm chart to use in adjusting warfarin, based on INRs. I found it simple to understand and use.