chat thought i shouldnt skip doese!

[Diesel]

hello everyone! Ihope all is feeling well. Im dealing with an upper resipitory infection and was put on antibiotics.. and i think its causing a problem!!!

i tested my INR today.. 4.8 i called it in and my cardio said skip a dose! he likes my levels to be 3.0-4.0 then i was told to take a 5 tomorrow (thursday)

so i was all about this until it was mentioned on tonights chat [which there was only 3 people tonight ] And there, i was advise NOT TO SKIP my dose... so now what to do?

Any thoughts on this??
Thanks for the input ahead of time!
Diesel

 

[geebee]

The MOST I would do for a 4.8 is take a half dose today and go back to regular dose and test again in 4 days. Since I home test, this is easy.
I can usually tell if my INR is too high due to gum bleeding, bruises, etc. If I test at a 4.8 but nothing else is going on, I will not make a change and just retest in a few days. Spinach salad and V8 - here I come!!!!!

 

[Ross]

It depends on how fast you bottom out. Have you ever skipped a dose before and see the result of skipping it? If not, I'd follow his instructions, but hold no more then one dose. Usually we just take a half dose and pig on something with Vit K and were fine. What antibiotic are you on? Most of them will cause a rise in INR, so it may make a difference as to what you should do.

Example, I tested 4.4 today and I've been fighting CHF. I'm finally losing some of the excess fluid and I'm not as diluted as before, so my INR is beginning to climb. I'm skipping tomorrows dose and lowering my overall weekly dose by 10%. That should have me back in range next week. This is just an example and doesn't apply to you obviously.

 

[Karlynn]

When did you start the antibiotic? If it's been in the last 3 days, your INR may continue to go up, so I don't think holding a dose will hurt. I still don't understand why the first knee jerk reaction for an INR less than 5 is to hold a dose - particularly for you, since you have a range of 3-4. 4.8 isn't that high.

I usually choose to do an overall weekly dose adjustment rather than hold a dose. I take an average of 10 mg a day and holding a dose makes me swing the other way. Many times, like GeeBee, I'll take half a dose and resume my usual dose.

 

[Blanche]

Diesel:
Will you please tell up what dose you are taking now?

It seems your instructions have two parts: 1) hold one dose, 2) take 5 tomorrow. It would help to know what your weekly total is.

Blanche

 

[Diesel]

hi everyone!

Im currently taking the Z pack. its like 2pills (monday) and then one pill each other day until 5 days. So far ive taken monday, tuesday and wednesday of the antibiotic.

I usually take 6mg everyday... (well at least the last few weeks i have been!) occasionally in the weeks before a 10mg might be needed..

So anyways i was told to skip tonights doese and just take a 5 for tomorrow and retest again friday....

SO there it is.. hope it clears up confusion... and my delema... take the coumadin tonight or not...

Do we ever get this pill undercontroll???
Diesel

 

[Blanche]

Sure, we get it undercontrol....for the most part.

This is my opinion. The person who is regulating your anticoagulation does not fully comprehend how Coumadin/Warfarin works. You have been told to hold a dose today and take 5.0 tomorrow instead of 6.0, and to test on Friday. It generally takes abut 3 days for a change in dose to show up in the INR. Z-pack is one drug that is well known for increasing INR in some people. When you are done with the antibiotic, your INR is likely to drop back to where it was, or thereabouts. And, if you skip a dose today and take 1.0 less tomorrow, your INR is most likely to drop beyond your target range. It isn't rocket science and it isn't exact. But, in this case, you know the likely cause of your INR increase.

THere are many other posts here on this same subject. You might want to search out some of these. In any event, good luck with whatever you do.

Blanche

 

[Karlynn]

Z-pack really raises my INR. Everyone does react differently tho'. Blanch is right, Friday's test won't give you much valuable information, other than to tell you if your INR is higher - meaning the Z-pack wasn't done working it's evil on your INR. I don't think it will hurt to adjust your dose a little temporarily, but I would caution you against following any instructions that lower your regular dose until you find if you INR drops again after the Z-pack is out of your system.

 

[Diesel]

Thanks everyone for your help.. I tell you what i am documenting everything in my little book. What i took when, and what my results were. THAT WAY... if and when i get sick again... i can look back and compair.. Cause we all know we will be dealing with this for the rest of our lives so eventually i'll get it right!!!

I guess i'll now have to wait and see what the results show over the next week. But thanks again for ALWAYS being there!!!!

Diesel

 

[Guest]

I have never had anyone who keeps a book have a bad outcome because they messed up.