Coumadin Doses

[Cooker]

I know this has been covered but I have a simple question. I have noticed people are using a wide range of doses to maintain their INR. I am on (what I think) is a low (5mg/2.5mg) dose compared to most. I saw where someone said they were on 12.5mg daily.

Should I explect mine to change? If it does that would mean that I am not stable I have been between 2.5 and 3.0 since four weeks post op (I am 6 months now), this without a change in my daily dose. Just kind of wondering if my INR could start flopping around with no change to diet, exercise etc.

Thanks,

Tom

 

[Karlynn]

It may change....and then again it may not. My dose has gradually increased over the years. I currently take an average of 10/day.
You need will most likely increase if you add more exercise to your routine. But that should happen gradually. At 6 months out, your body is still recovering and your dose may change. Or it may not.

The only thing to remember is that the dose needed to keep your INR theraputic, is the correct dose for you. There is no such thing as being on too much Coumadin. I had a nurse look at my dose and say "Wow, you need to tell your doctor you are on too much Coumadin."

 

[mtkayak]

I'm no expert but that's great your levels are in target range so no use to change anything. Consider yourself lucky I think the avearge for most people is 5mg. a day but it can be range anyhwere from 2mg-20mg people have to take. It just depends on the person. I use 5mg tablets. My doages are 5mg for MWFSS and 7.5 mg for TT. I just break the 5mg tablets to get the 2.5mg. Certain things can affect the levels like Vitamin K foods and alcohol. People claim that when they travel their INR goes up and other various reasons. Only you will know how your INR will be effected eventually. It sounds like it takes a while to you really get to know how things effects your levels.

Experts please chime in

 

[Blanche]

Can you expect it to change? I would say bet the ranch on it.... Anytime anything affects your liver or colon, it will affect your anticoagulation. Remember, too, that the body also makes its own Vitamin K. In your case, Cooker, the more you heal, the more vitamin K can be produced in your body. Life changes, even vacations, might also change your INR. Some folks swear that summer temperatures affect the INR...I swear with them.

You might want to check around in the reference section. THere are some neat articles that discuss the very questions you are asking. And, if you have not gone over Al Lodwick's materials, this might be a good time to have a look.

Kind regards,
Blanche

http://substance.altmedangel.com/vitk.htm

http://arbl.cvmbs.colostate.edu/hbooks/pathphys/misc_topics/vitamink.html

http://www.ccjm.org/pdffiles/Jaffer...=0&order=r&uq=%www.ccjm.org%&cq=&id=4384caff7

 

[Ross]

I=It's
N=Never
R=Right

 

[gcmhphleb]

How much coumadin is to much!!

How much coumadin is to much!!

I had surgery in Feb, 06, for mitrial vallve replacement and tricuspid repair,, I take 13 mg of warafin everyday, I was started on 5mg and worked my way to 13 because my blood is usually to thick, When I asked my doctor, he said the right dose is the one that keeps the INR in range. I used to work in the lab and I recall that as the weather changed, so did peoples INRs,It seemed the colder the weather, the thinner the blood. But who are we to guess at the results. The blood test never lie. I would really hope someone comes up with a better coagulation drug. This is so scary....And trying to eat the right food has become such a challenge

 

[bvdr]

I had surgery in Feb, 06, for mitrial vallve replacement and tricuspid repair,, I take 13 mg of warafin everyday, I was started on 5mg and worked my way to 13 because my blood is usually to thick, When I asked my doctor, he said the right dose is the one that keeps the INR in range. I used to work in the lab and I recall that as the weather changed, so did peoples INRs,It seemed the colder the weather, the thinner the blood. But who are we to guess at the results. The blood test never lie. I would really hope someone comes up with a better coagulation drug. This is so scary....And trying to eat the right food has become such a challenge

I hope all is going well for you since your surgery. Your doctor is right that the right dose is whatever keeps you in range. If it takes 2.5mg a day or ten times that much. There were a couple of things in your post that make me think you are making this harder on yourself than it need to be. We have a saying around here that you should dose the diet rather than keep adjusting the diet for the dose. Eat reasonable and with foods that you like and then adjust the warfarin dose accordingly. Blood can be thinner or thicker but not from warfarin. Many people do refer to warfarin as a blood thinner but it is only an anticoagulant. Spend some time here on this site and also on warfarinfo.com and get really familiar with the drug since you are on it for the long haul and there is nothing to replace it in the immediate future.

 

[Ross]

I had surgery in Feb, 06, for mitrial vallve replacement and tricuspid repair,, I take 13 mg of warafin everyday, I was started on 5mg and worked my way to 13 because my blood is usually to thick, When I asked my doctor, he said the right dose is the one that keeps the INR in range. I used to work in the lab and I recall that as the weather changed, so did peoples INRs,It seemed the colder the weather, the thinner the blood. But who are we to guess at the results. The blood test never lie. I would really hope someone comes up with a better coagulation drug. This is so scary....And trying to eat the right food has become such a challenge

Yes as bvdr said above, eat the diet that you normally eat. If it includes greens and lots of vitamin K, so be it, then adjust the dose of Coumadin to match your diet. DO NOT DIET THE DOSE.

Forget everything that you learned or heard in the lab. Most of it is simply not true. Seriously, check www.warfarinfo.com and hang around here long enough and you'll know BS when you hear it.

 

[Guest]

Whoever is managing your warfarin is doing a woefully inadequate job. After 6 months, you should know that warfarin does not thin the blood. By telling you what to eat, your warfarin manager is in effect saying, "I know what dose is best for you and you had better eat the so that you will conform to my plan." This is utter nonsense. As Ross said, eat what you like and let them change the dose.

The only true thing that you came uo with is that the right dose for you is the one that keeps the INR in range. It is not common, but not rare either to have someone taking 25 mg per day.

 

[Karlynn]

G-PHLEB, You will also want to give this thread a read.

http://valvereplacement.com/forums/showthread.php?t=17116