Covid vaccine affecting INR?

[VWalk]

I received my 2nd Pfizer shot about 4 weeks ago. I'm meticulous regarding monitoring my INR at home. I'm having issues with my INR being too high. I like to be 2.5-3.0, but last night I was 3.7. I keep finding my self above 3.5 and I'm testing twice/week to try and figure it out. My diet and alcohol consumption hasn't changed. In fact, I quit drinking in an attempt to attain some stability with my INR. Has anyone experienced elevated or inconsistent INR readings since the vaccine?

 

[dick0236]

I have had no disruption to my INR by my Covid shots in late Feb, 2021. My range is 2.5-3.5 and I have been consistent at +/- 3,0 for many months. I also had the Pfizer shots.

 

[tom in MO]

It's not the vaccine it's you and your physiology. You need to adjust your dose.

Drinking does not effect your INR. Start drinking again. It will help your mindset concerning the high INR

Every so often I've needed to change my dose for reasons unknown to me, the clinic or my cardio. Testing twice a week is not really needed since dose adjustments take about 5-days to be seen. Testing will not lower your INR.

If I were you I'd take a 1/2 dose and drop my daily dose by 10% test again in 5-7 days. If in range, keep that dose and test again in 5-7 days to see if you have reached a new equilibrium.

 

[pellicle]

I keep finding my self above 3.5

have you adjusted your dose in response to the new INR reading?

Remember the "intention to treat" is INR not your dose.

I myself often need to make minor dose adjustments throughout the year.
Are you self managing?

 

[VWalk]

Yes, I self manage and meticously keep track on a spreadsheet. You're right, I need to focus on my INR and not my dose. I'm not doing that. The vaccine is probably just coincidence. My daily dose is normally 6mg. I think I'll drop to 5.5mg and check again in 5 days. Thoughts?

 

[dick0236]

Yes, I self manage and meticously keep track on a spreadsheet. You're right, I need to focus on my INR and not my dose. I'm not doing that. The vaccine is probably just coincidence. My daily dose is normally 6mg. I think I'll drop to 5.5mg and check again in 5 days. Thoughts?

That makes sense to me.

 

[user 16827]

If 6 is your normal dose and all other variables are the same then things should stabilise again.

I like to make small adjustments to steer away from the roller coaster so 0.5 reduction I would be happy with and retest in 5 days .

3.7 would not worry me one bit either .

Enjoy the drink too

 

[user 15848]

have you adjusted your dose in response to the new INR reading?
Remember the "intention to treat" is INR not your dose.

Everything is always changing, so i agree 100%, treat the INR not your dose;
I asked my family doctor 3 years ago while experiencing something similar
why INR went up and down even though all diet was same; his "professional"
answer was : "Rolled the eyes up and down and said "We dont know", just adjust
the dose, and test....

 

[tom in MO]

Yes, I self manage and meticously keep track on a spreadsheet. You're right, I need to focus on my INR and not my dose. I'm not doing that. The vaccine is probably just coincidence. My daily dose is normally 6mg. I think I'll drop to 5.5mg and check again in 5 days. Thoughts?

Taking 0.5 day less may stabilize you but it will be at 3.7 not 2.5-3. You need to drop and stabilize. If I was 3.7 and should be 2.5-3, I'd first take 1/2 dose of 3 to get in range and then do the 0.5mg drop in daily dose to see if I could keep it there.

 

[VWalk]

Thank you everyone. I appreciate this group so much. I'll work on dropping into range and then stabilizing.

 

[pellicle]

I'll work on dropping into range and then stabilizing.

Not everyone stabilizes, probably half of us don't.
Myself I'm a work in progress.
PM me here if you want a hand.

 

[Chuck C]

I received my 2nd Pfizer shot about 4 weeks ago. I'm meticulous regarding monitoring my INR at home. I'm having issues with my INR being too high. I like to be 2.5-3.0, but last night I was 3.7. I keep finding my self above 3.5 and I'm testing twice/week to try and figure it out. My diet and alcohol consumption hasn't changed. In fact, I quit drinking in an attempt to attain some stability with my INR. Has anyone experienced elevated or inconsistent INR readings since the vaccine?

I've had the Moderna vaccine, both shots, and have not had any movement in my INR from them.

 

[pellicle]

Hi

Yes, I self manage and meticously keep track on a spreadsheet. You're right, I need to focus on my INR and not my dose. I'm not doing that. The vaccine is probably just coincidence. My daily dose is normally 6mg. I think I'll drop to 5.5mg and check again in 5 days. Thoughts?

sorry, you're asking me? I missed it because you didn't reply (quoting me, thus trigging a notification or mentioning me (for example type @ and my username, pick the one from the drop down or just type it in full ... eg: @VWalk )

I'll need a few weeks of data please

date | INR | dose

also I'm not entirely sure why you've picked 2.5 ~ 3 as a range (its a bit tight), are you aortic or mitral (your bio says nothing about this and if you mentioned it I'm sorry but I missed it.

I'm inclined to view that if you drop to half a dose (meaning 3mg is half of your usual 6) then continue on 5.5 you may indeed recover back to somewhere under 3.7 but still above your target.

Also there is nothing serious or dangerous about being 3.7 as even INR = 5 just increases risks, it does not "cause bleeds" ...

 

[VWalk]

Hi

sorry, you're asking me? I missed it because you didn't reply (quoting me, thus trigging a notification or mentioning me (for example type @ and my username, pick the one from the drop down or just type it in full ... eg: @VWalk )

I'll need a few weeks of data please

date | INR | dose

also I'm not entirely sure why you've picked 2.5 ~ 3 as a range (its a bit tight), are you aortic or mitral (your bio says nothing about this and if you mentioned it I'm sorry but I missed it.

I'm inclined to view that if you drop to half a dose (meaning 3mg is half of your usual 6) then continue on 5.5 you may indeed recover back to somewhere under 3.7 but still above your target.

Also there is nothing serious or dangerous about being 3.7 as even INR = 5 just increases risks, it does not "cause bleeds" ...

Sorry about that. I was on a mobile device and forgot to 'post reply'. I'll send you a PM and would greatly appreciate you reviewing my INR history. I certainly welcome your advice!
For some reason, my bio shows in my profile in the signature section, so I need to figure out why it isn't showing on the site. I have an aortic mechanical valve. My cardiologist set a range of 2.0-3.0 since I'm active. My "personal goal" is to stay 2.5-3.0. I'm glad to see your comment about the 3.7 INR.

Here's my manually entered signature:
Aortic Root Replacement (23 cm St Jude mechanical) and Ascending Aortic Aneurysm Repair. 06/21/2016, 51 years old. University of Kansas Medical Center, Dr Gregory Muehlebach

 

[pellicle]

My cardiologist set a range of 2.0-3.0 since I'm active. My "personal goal" is to stay 2.5-3.0. I'm glad to see your comment about the 3.7 INR.

Ok
Makes sense
I look forward to the data, just a few weekly readings will do
Have you seen my blog about this?
https://cjeastwd.blogspot.com/2015/10/managing-my-inr-example.html
https://cjeastwd.blogspot.com/2014/09/managing-my-inr.htmlIn particular this graph mentioned in that post

Also on mobile you can reply by selecting

Then tap reply.

PS 10pm here, so I'll look at that pm in the morning.

 

[VWalk]

Ok
Makes sense
I look forward to the data, just a few weekly readings will do
Have you seen my blog about this?
https://cjeastwd.blogspot.com/2015/10/managing-my-inr-example.html
https://cjeastwd.blogspot.com/2014/09/managing-my-inr.htmlIn particular this graph mentioned in that post

Also on mobile you can reply by selecting
View attachment 887829

Then tap reply.

PS 10pm here, so I'll look at that pm in the morning.

It's been a couple years since I've read your blog. I'll look again (thanks for reminding me).
Talk tomorrow!

 

[CDBarker]

Had the Johnson & Johnson back in March and i had no changes at all

 

[ATHENS1964]

Had Phizer 2 weeks ago not problem with INR .

 

[gerrychuck]

I had my first dose of AstraZeneca in March, followed by Moderna 2 weeks ago today. My INR had been well stabilized at 3.0 + or - on 6 mg/day prior to that, with predictable variation according to alcohol intake, etc. The week after my second dose, it was 3.4. No big deal; I had been off my usual exercise routine and taking some Tylenol due to side effects, so that didn't surprise me. Adjusted my meds a bit and resumed my normal routine. Normally when I do that I will see an INR under 3 the following week. This week it was 3.4 again, with none of the factors present that normally would push it up, so I am wondering if the vaccine has in fact had a modest effect. We shall see over the next few weeks.

*Side note: Tom states above that alcohol has no effect on INR; that may be true for him, but it is absolutely not true for me, and the pharmacists who run our local warfarin management program tell horror stories of younger clients coming in after a party weekend with INRs in the stratosphere. For me it is absolutely the most predictable variable in determining my INR each week. Another couple of data points FWIW

 

[ATHENS1964]

I had my first dose of AstraZeneca in March, followed by Moderna 2 weeks ago today. My INR had been well stabilized at 3.0 + or - on 6 mg/day prior to that, with predictable variation according to alcohol intake, etc. The week after my second dose, it was 3.4. No big deal; I had been off my usual exercise routine and taking some Tylenol due to side effects, so that didn't surprise me. Adjusted my meds a bit and resumed my normal routine. Normally when I do that I will see an INR under 3 the following week. This week it was 3.4 again, with none of the factors present that normally would push it up, so I am wondering if the vaccine has in fact had a modest effect. We shall see over the next few weeks.

*Side note: Tom states above that alcohol has no effect on INR; that may be true for him, but it is absolutely not true for me, and the pharmacists who run our local warfarin management program tell horror stories of younger clients coming in after a party weekend with INRs in the stratosphere. For me it is absolutely the most predictable variable in determining my INR each week. Another couple of data points FWIW

Alcohol does not affect my inr I am talking about normal doses and not excessive. What affects it is cashews and peanuts throw my inr.