coumadin dosage

[eckw]

My INR range was set to 2-3. I had my aortic valve replacement surgery Oct 12 and stay in hospital for 3 weeks. When discharged last monday, my INR was 2.4. When my family doctor took over the INR fluctuates from lowest 1.9 to 2.5. I do lab test every other 2 days and my family doctor usually called to tell me the dosage. I had test yesterday and today up to now he still has'nt called to tell me the dosage. My dosage he gave me is alternatively 7.5 and 10 mg. Since he has;nt called, my wife gave me 10mg same as I took yesterday. I don't know my INR level as of last lab test, and tommorrow is his day off. The earliest day I can see him is Sunday, I will go to his office and ask him. I am really very uncomfortable with this and not sure if i am taking the correct dosage. Anyone can advise me how to deal with this situation.

Thanks

 

[Rich]

I get my tests done at the lab of our local hospital.
I also had similar problems with the doctor's office, not calling me for several days after my test.
I then called the hospital and got transferred to the lab.
They told me I was welcome to call anytime(24-7) and they would be happy to give me my results. They even provided a phone # to get right to the lab.
Is there any chance you could call the lab yourself?
Rich

 

[Karlynn]

I'm not quite sure what you mean by saying you get tested "every other 2 days", but regardless, if you are testing more than once a week, it's too much. Coumadin is a slow metabolizing drug. It takes 3 days for a dose to show up in your INR #. So in other words, the pill you take today won't register with your INR until Monday. If you test and change dosages any more frequently than weekly, your INR will never stabilize. The exception is if your INR is way too high or too low, then testing more than once in a week is warranted.

You should get your INR # and any dosage change the day you are tested. That number means next to nothing the next day or after.

 

[eckw]

coumadin

coumadin

Eversince I came out from hospital Monday last week, I had blood test every other day and the family doctor tells me my dosage the day after the test. (the result was sent to my family doctor the day after the test). Starting this week, I did my test twice a week. This is the first time he did'nt call back, when I call the clinic, their answering machine said message full. I don't know what's happening there. I should go to the clinic and see him (5 min. drive from home ). But he said he will contact me about the result. If this become a pattern of not responding back, I think I need to go other route as Rich said, I may have to go back to my hospital for test and dosage prescription, maybe I can check with the hospital.
I don't know if I can enquire the lab for results as they usually responded back to the family doctor who request the test. Thanks for your advice. Another question, is 7.5 to 10 mg is high dosage? what are the usual dosage everyone takes.

Thanks

 

[Ross]

They are testing you too much and you need to know the results the SAME DAY, not tomorrow or whenever, but TODAY. You need to find someone who knows what they are doing.

 

[Guest]

You are getting substandard care and Ontario has the largest collection of warfarin specialists of any place in the world.

 

[geebee]

Another question, is 7.5 to 10 mg is high dosage? what are the usual dosage everyone takes.

Thanks

Dosage varies quite a bit from person to person. It depends on size, weight, how you metabolize the drug, etc. I should think you are probably on the high end of normal for dosages but I am not sure. I alternate 2.5 & 5mg tablets.

I agree that your level of care is awful. You are testing too often and will be chasing your tail forever by testing more than once a week. In addition, you should receive instructions the day you have the test so you can make any changes immediately. Look for another caregiver.

 

[Ross]

Or however Al put it, There is no right or wrong dose, the correct dose is the one that keeps you in range. Something to that effect.

 

[Eowyn Rose]

Hi

Although you are not cared for as you need to. You will be alright. My doctors try to figure out my Warfarin need for about a year. (I am an exeption so they tell me.) I am taking a dosage of 11 and my INR is still flactuating. Understandable it was very scary the thought of to much Warfarin or to little. In the beginning I was tested testing twice weekly not getting the result when needed etc. I also was very worried on the dosage which got higher and higher.
However I now feel it is not such a big deal anymore if you are in a save range you will be fine. I also acceped that many doctors are quite challenged by Warfarin management.
I still don't know much about my warfarin management (still learning) However there are many members in this forum with great understanding who were able to put my mind at peace with great advise.
Well I got stuffed around, tested unnessessarly, worried about the competance of the doctors and messed it up myself. However most of the time I was in a save range. It just seems now that it could all been made less dramatic by the medical profession.
Take care
Ewoyn Rose

 

[Eowyn Rose]

Hi

Although you are not cared for as you need to. You will be alright. My doctors try to figure out my Warfarin need for about a year. (I am an exeption so they tell me.) I am taking a dosage of 11 and my INR is still flactuating. Understandable it was very scary the thought of to much Warfarin or to little. In the beginning I was tested testing twice weekly not getting the result when needed etc. I also was very worried on the dosage which got higher and higher.
However I now feel it is not such a big deal anymore if you are in a save range you will be fine. I also acceped that many doctors are quite challenged by Warfarin management.
I still don't know much about my warfarin management (still learning) However there are many members in this forum with great understanding who were able to put my mind at peace with great advise.
Well I got stuffed around, tested unnessessarly, worried about the competance of the doctors and messed it up myself. However most of the time I was in a save range. It just seems now that it could all been made less dramatic by the medical profession.
Take care
Ewoyn Rose

 

[eckw]

I called the clinic to asked my INR of Thursday test. It was 2.3. They said they has not received the report, they have to call for it. I did the test in the afternoon to avoid the long line up and end up in delay of report. Anyway, my doctor should call me at least to advise the dosage. Anyway, tommorrow I will be seeing to clarify all these. I believed I am testing too frequent. I have to research to other ways to get better support on coumadin management. Thanks for your help and advice, will update you guys on this issue.

Thanks

Ed

 

[Ross]

I called the clinic to asked my INR of Thursday test. It was 2.3. They said they has not received the report, they have to call for it. I did the test in the afternoon to avoid the long line up and end up in delay of report. Anyway, my doctor should call me at least to advise the dosage. Anyway, tommorrow I will be seeing to clarify all these. I believed I am testing too frequent. I have to research to other ways to get better support on coumadin management. Thanks for your help and advice, will update you guys on this issue.

Thanks

Ed

You might as well forget getting the number now, it's no good to you anymore. This is why it is imperative to have the results on the same day as the test. Todays number given to you 3 or 4 days later is of no value.

 

[ALCapshaw2]

It sounds like your PCP is CLUELESS when it comes to managing Coumadin.

See if you can find a REAL Coumadin Clinic. Al Lodwick has posted a link to a list of Coumadin Clinics in the past but I don't remember it. Try searching for keyword "Coumadin Clinic", or ask Al Lodwick.

Ask your Cardiologist if he knows of one, or someone capable of managing your Coumadin properly.

'AL Capshaw'

 

[Guest]

www.acforum.org and click on clinics.

 

[Rain]

I'd learn as much as possible about warfarin... then invest in a machine... seriously

I'd learn as much as possible about warfarin... then invest in a machine... seriously

They had a release form at the hospital lab here in my town that I signed when I got home -- before I got a Protime machine. By signing the form I could call and get the results from them myself. I?m not 100% sure if this was able to be done because of my little town or not. Sometimes I would call and they wouldn?t want to tell me, so I?d have to tell them that this is the way we ALWAYS do it... and that they had a form signed and on file..... Or I?d have to call back later impersonating my cardio?s nurse. That worked too.

Thank goodness within about 6 months of my operation I was able to convince my cardio I needed my own machine. Between him, me and QAS we managed to get me one and it?s been soooooooooooooo much easier since then. For all of us. LOL

 

[eckw]

Thanks for the information. I am in Toronto. However, I found a Warfarin clinic at Toronto General Hospital. I will check with the hospital where I had my surgery (SunnyBrooke Hospital) first to see if they have warfarin clinic. My family doctor at last called back, I asked him how I can manage my coumadin if the feedback is so late and I can't remembered what he said. I asked where I can get same day result he said unless I stay in hospital i won't get same day result. Anyway, arguing with him is waste of time, starting next week I will be on weeking test, seems to be now he get my coumadin dosage in range. I probably on weekly test for a few weeks before extending to 3 weeks or monthly. In the meantime, I will look into other venues and if he still cannot manage I will switch.

Hope I will get my coumadin under control. Thanks everyone for your info and advice.

 

[Rush20]

I always wondered if you take a lower dosage of coumadin, whether or not the actual side effects of the drug are reduced? I take 5mg daily and have been very consistent over the past year averaging 2.9 and never going lower than 2.5.

My question is that if someone takes 10mg to maintain a 2.5 - 3.5 INR, is the drug negatively effecting the body more than someone who takes 5mg? I guess what I'm getting at is that can you supplement the coumadin with natural foods to raise or lower the INR limiting the amount of Warfin?

 

[Ross]

I think what you would be doing is more dangerous because then your inhibiting what the drug is being used for. Bottom line is, it's saving your life or at least keeping you from living one as a vegetable.

 

[Guest]

Worry about something else besides the dose harming the body. We have one man on here who has been taking it for 45 years and many others over the 25 year mark.

Trying to supplement warfarin with some vegetable will greatly increase your risk of you being a vegetable.

 

[Rush20]

Worry about something else besides the dose harming the body. We have one man on here who has been taking it for 45 years and many others over the 25 year mark.

Trying to supplement warfarin with some vegetable will greatly increase your risk of you being a vegetable.

Thanks. Don't worry, I'm not tinkering with my diet to offset the coumadin. I was just curious why there is such a large discrepency in dosage. I'm 6'2" - 210 lbs. and have been consistent at 5mg per day for close to a year. I've read other posts whereas a 120 lb woman has to take 10mg and 12mg. Does the discrepency of blood thickness differ that greatly from one person to another?