Crazy INR HELP!!!

[DinahS]

Hello everyone!!

I need some dosage help. I take 6 mg 4 times (Sun, Tues, Thurs, Sat)a week and 6.5 mg 3 times a week (Mon, Wed, Fri). My INR was 5.0 on 7/13. My INR has always been 2.5 to 2.9 and I have never had any problems. I test once a month by vein draw. My coumadin lady told me to hold a dose on 7/13 night and then take 5 mg on Fri & Sat and then take 6 until I tested again. I went against her advise and did not hold on Thurs...I took 5 mg instead and then took 5 on Fri & Sat, then started back on regular schedule on Sunday. I tested on Fri (7/21) and my INR was 1.8. So today she told me to take 7 mg until I test again on this Friday. Does that sound right? Should I just go back to normal? Should I test before Friday? Thanks!

 

[Karlynn]

I'm a little confused. Your original dose was 43.5 /week. You then took 5 for 3 days in a row and then went back to your original weekly dose schedule. Then on Friday you tested 1.8.

First I'm thinking the 5.0 INR was a bogus reading. The reason I don't like lab draws is because you don't know the "chain of custody" of the vial of blood, and it's hard to retest.

If you take 7/day and test on Friday, that's 49/week. What have you taken since your 1.8 test on this last Friday?

I'm thinking the 7/day may push you back into range more quickly than going staying on your original dose of 43.5/week. (Since you've really been on it for a week already and your INR is low.)

The reason I doubt the 5.0 reading is that you only dropped your weekly dose by ~10% overall and got a 1.8 INR. From a 5.0 on a moderate dose, that seems a bit much.

Is there a place that does finger sticks around you?

 

[DinahS]

No

No

My doctor nor the hospital do the finger stick. I wish they did. I have been trying since March to get a machine and my insurance keeps denying it.

That is why I didn't hold on the night she told me too. I just thought I should have re-tested and not changed my dosage. I shouldn't have second guessed myself and it would be fine now, I am sure. I did go to my PCP (different from where I went when it was 5.0) to do the vein draw on Friday when it was 1.8. I am not sure that is truly correct either. I normally go to the hospital clinic, but I didn't go in to work on Friday and so went to my PCP instead. I guess I should just do the 7mg and go in like Wed and re-test. Would you wait that long or go tomorrow? I am freaking that it's 1.8...if that's true..b/c that was Friday and it's Monday afternoon. I don't even know why it went to 5, if that was true b/c I haven't changed a thing. I am a little more stressed b/c I am building a house, but I am always a little stressed.

I just wish I had a home tester. Thanks!

 

[Karlynn]

Dinah, this thread has a post from Al Lodwick about what he does for a 5.0 INR reading. http://valvereplacement.com/forums/showthread.php?t=16933
which is nothing, and retest in a week.

Your instincts were good. The longer you are on Coumadin, the more you will trust yourself too.

Good luck on getting that home unit!

 

[geebee]

Any change you make today won't show in your INR until probably Thursday so testing earlier than that will not really help. I would definitely take 7mg/day until later in the week, test and then see where you are.
Karlynn is right about the test possibly being bogus. With no changes, it is unlikely you went from 2.5 to 5.0.
Keep trying for the home tester.

 

[Ross]

I'm thinking go back to your original schedule. I'm pretty sure that 5.0 was bogusghetti. If it were me, I'd go back to the dose where I was in range the most.

 

[Guest]

If people (even warfarin "experts") would get over the fact that a 5.0 is not particularly dangerous, things would run a lot smoother. I'm willing to bet that a lot of them will drive 50 in a 35 zone one the way home from work. This is probably more dangerous than an INR of 5.0 but they refuse to see it that way. In my way of thinking, INRs of less than 8.0 do not qualify as crazy. They are just variations.