Coumadin

[Tony]

I am a warfarin user, 5mg daily. Over the last 3 month I have had 2 episodes of a bloodshot eye. After the last episode I began splitting my tablet in two, taking 1/2 in the morning and 1/2 in the evening. My idea was to have a more uniform level of medication. When I told my doctor he said no one takes more than one daily dosage of coumadin (or its equivalent). He told me to go by the book and take it once daily.

Any comments?

 

[Ross]

Hello and welcome Anthony

That's the first I've ever heard of anyone doing that. Interesting concept, but I'm not sure that it really does much since it takes 3 days for dosage changes to show up. It makes sense, but I'm wondering if its practical.

Oh Mr. Lodwick, we need some of that expert input here please.

Al should be around sometime to offer his thoughts on this. Until then, kick back and relax. Read around and have fun.

 

[JimL]

Welcome, Anthony, from another Michigander!
I also am a user, currently more like 6 mg a day. I think you have a valid point, but perhaps carried to an extreme. It troubled me when my dosage one day was twice as much as the previous day. I had my card write me two prescriptions, for 5s and 6s, so that I can take nearly the same amount each day.

 

[Guest]

Warfarin is very long and very slow acting.

Many medications are cleared from the body in 3 or 4 hours after you take them. This is why multiple daily doses are needed.

It takes about 2 days for warfarin to be cleared from the body. So only one dose per day is NEEDED. But it will make no difference if you take it twice a day - if you don't forget the second dose.

When I have people taking varying doses, I usually give the extra doses on Monday and Friday. That way there is 2 days or 3 days between the doses. Buying two different strengths of warfarin only makes a difference in the billfold, not in patient outcomes.

I was just talking to a friend of mine about some physician assistants who got burned out in the ER and tried a warfarin clinic. They could not stand the clinic because our idea of an adrenalin rush is to give somebody a warfarin dose increase and wait a week and see what happens. It turns out that they were not as burned out as they thought and are trying to get back to the ER!!

After more than 20,000 paatient visits to my clinic, I have decided that you can do almost anything you want with warfarin doses so long as you only change by 10 to 20% up or down and don't get obsessed with testing too often.

My major bleeding rate is about 1 per 33 patient years and my major clotting rate is about 1 per 100 patient years, so I know that my way works.

 

[Blanche]

Anthony:

Welcome to a most wonderful site filled with tons of information and some of the best people you will ever know. Hope you will visit often, learn some, share some, and get to know us.

When I first read your post, I was going to respond the the splitting of your dose of Coumadin. Others have answered that already. But, I wondered if that was the centeral concern.
Just my opinion, but shouldn't the first question be, "What is causing the bloodshot eyes?" It appears to me that there are many more reasons for a bloodshot eye, other than Coumadin. Actually, if your INR is in range, Coumadin is the very last thing I would consider. Some years ago when I lived in Buffalo, New York, I got bloodshot eyes every winter....probably aggravated by sinus problems. I've never taken Coumadin. Maybe you should take this up with your eye doctor.
Kind regards,
Blanche

 

[Tony]

Coumadin

Thanks folks,

The diagnosis of Coumadin causing the the bloodshot eye was not mine but came from the physicians who monitor my I & R. They do not think it is an eye problem, but I will bring it up with my ophthalmolgist at my next visit.

Tony

 

[Rich]

Tony,
It's nice that you found this site.
My name is Rich and I am a retired design engineer living here in Shelby Twp.
I have a St. Jude mechanical aortic valve installed on 7-29-96.
If I can be of any help just let me know since I'm right around the corner.

Rich