Coumadin insert vs Cardiologists

[COLLEEN S]

I read some of the coumadin insert and it actually says:
Mechanical and Bioprosthetic Heart Valves: For all patients with mechanical prosthetic heart valves, warfarin is
recommended. For patients with a St. Jude Medical (St. Paul, MN) bileaflet valve in the aortic position, a target INR
of 2.5 (range, 2.0-3.0) is recommended. For patients with tilting disk valves and bileaflet mechanical valves in the
mitral position, the 7th ACCP recommends a target INR of 3.0 (range, 2.5-3.5). For patients with caged ball or caged
disk valves, a target INR of 3.0 (range, 2.5-3.5) in combination with aspirin, 75 to 100 mg/day is recommended. For
patients with bioprosthetic valves, warfarin therapy with a target INR of 2.5 (range, 2.0-3.0) is recommended for
valves in the mitral position and is suggested for valves in the aortic position for the first 3 months

This tells me, that the people who make coumadin say I should be 2-3 INR. Sorry but I had to point this out. Why do they say 2-3 and cardio's say 2.5-3.5 ?

 

[Ross]

There is nothing set in stone. It's the Cardiologists call. I too, am set at 2.5 to 3.5. Usually they want some of us that had clotting problems in the past, to be higher. Some just prefer it be that way. There is next to no difference between those ranges. Your talking about 4 to 5 seconds difference in clotting time.

Here is another chart:

http://www.valvereplacement.com/forums/showpost.php?p=383938&postcount=7

 

[Bina]

My surgeon told me 2.5----3.5
The only diff is that if my INR should be a bit low, like 2.4 or 2.3, then I know to bump it up a bit.
And if my INR is below 2.0 my doc prefers that I get a Lovenox shot....which has never happened in the last 3 years.
My "happy place" seems to be around 3.1

 

[lbecker]

Ross I saw mentioned by one person on one of the threads the algorithm chart is that
really a chart or is that an expression? If it is a chart where is it? Thanks, trying
to educate myself on this. Laura

 

[Ross]

Ross I saw mentioned by one person on one of the threads the algorithm chart is that
really a chart or is that an expression? If it is a chart where is it? Thanks, trying
to educate myself on this. Laura

Laura, Al Lodwick has one that he sells or if you make a $5 donation to his site http://warfarinfo.com/publications.htm item #1 or you can see another at this link below about half way down the page:

http://www.aafp.org/afp/990201ap/635.html

 

[lbecker]

Thanks, Ross

 

[Ross]

Ross:

That second 'chart' - from AAFP wasn't for dosing - it only suggested ranges for each type of heart history.

Once I finally get to be able to self test, I'll get Al Lodwick's chart or ask others on the forum about dosing (in case I'm way out of range)

There are charts on the AAFP site very similiar to whats on Al's pocket card. Once you get a handle on your correct dose, it's just a little tweak here and there to keep it in range.

 

[catwoman]

There are charts on the AAFP site very similiar to whats on Al's pocket card. Once you get a handle on your correct dose, it's just a little tweak here and there to keep it in range.

A lot of the charts say to drop or add 1 or 1/2 tablet.

I like Al's because you deal with percentages over a week's time. That may be difficult for the mathematically challenged, but I've found it fairly easy to conquer.

 

[Ross]

A lot of the charts say to drop or add 1 or 1/2 tablet.

I like Al's because you deal with percentages over a week's time. That may be difficult for the mathematically challenged, but I've found it fairly easy to conquer.

If you look at that site, they show basically the same thing as Al's charts, just a different format.

 

[olefin]

Colleen,
My surgeon and first Cardiologist said 2.5 to 3.5. Once I had to go to a GP doctor, he wanted to lower it. I fired him. My next and present Cardiologist wanted it lower but I didn't agree so he went along with me.

Hey, it's worked for almost 18 years, I'm not changing.