Different INR manager, different style?

[wcasey5]

I purchased my Inratio2 about 2 months ago, and my INR has been fine until last week, it dipped to 1.8. When I purchased my monitor I an now managed by a differnt organization, it changed from the local hospital clinic, to my cardio's office. I was on a dose of S-2.5mg M-5mg T-2.5mg W-2.5mg T-2.5mg F-5mg S-2.5 mg . At the clinic when my INR dipped, they would change my W dose to 5mg, or add another day, and my week would be balanced. With my Cardio, they changed my dose to 5mg for 4 days in a row, and 2.5mg for 3 days in a row. Does this kinda yo-yo my INR? should it be balanced like 5mg for a few days, 2.5, then back to 5mg?

Maybe I am worrying for nothing. I must say, when I took my INR last week it was back up to 2.5 . But that was at the end of the 2.5mg for 3 days.

Comments, questions, jokes?

Thanks

 

[AgilityDog]

If your total for the week is the same/similar with adjustments, you should be fine. That said, however, I believe it is better to alternate the higher and lower doses so your INR is more stable, rather than clustering the increased dosages and lower dosages. I'd say you are right, you'd have a built in roller coaster that way, though it should not be extreme.

This particular medical practice may find it easier for their patients to manage doing it their way.
Do what YOU want to do, it's the total dosage that really counts.

 

[ALCapshaw2]

I don't like Either Dosing Schedule. I prefer to keep the day-to-day variations on the small side, alternating high/low on a daily basis rather than 4 days of High Dose followed by 3 days of Low Dose. Where did this crazy idea come from?

With a supply of 2 different doses differing by 1 mg, you can vary your weekly dose over a 7 mg range with only 1 mg change from day to day. (e.g. 3 and 4 mg tablets allow you to vary from 21 to 28 mg with only one
tablet per day)

I also don't understand why your Weekly Dose was changed from 22.5 mg to 27.5 mg.

For 22.5 mg/week (average 3.2 mg daily) you could use the following schedule:
3.3.3.4.3.3.3 = 22 mg/week or,
3.4.3.3.3.4.3 = 23 mg/week

For 27.5 mg/week (average 3.9 mg/daily) you could use the following schedule:
4.4.4.3.4.4.4 = 27 mg/week or
4.4.4.4.4.4.4 = 28 mg/week

'AL Capshaw'

 

[dick0236]

Clustering the doses doesn't make sense to me either. I'd buy a pill box and spread the doses more evenly like the hospital clinic was doing.

 

[wcasey5]

Great ideas on the total dose for the week. I only have 5mg tabs, so I either cut them in 2 or take the whole thing. I think I will stratigically spread out the dosage and make it as even as possible. thanks

 

[Ross]

Great ideas on the total dose for the week. I only have 5mg tabs, so I either cut them in 2 or take the whole thing. I think I will stratigically spread out the dosage and make it as even as possible. thanks

Yes because if you don't, you'll be high at one end of the week and low on the other.

 

[catwoman]

Yes because if you don't, you'll be high at one end of the week and low on the other.

And it will help ensure your INR results more acccurately reflect your dosage.

 

[wcasey5]

Yes because if you don't, you'll be high at one end of the week and low on the other.

And it will help ensure your INR results more acccurately reflect your dosage.

That's what I was thinking! Thanks guys.

 

[ALCapshaw2]

Great ideas on the total dose for the week. I only have 5mg tabs, so I either cut them in 2 or take the whole thing. I think I will stratigically spread out the dosage and make it as even as possible. thanks

FYI, dosing is always based on the Weekly Total and then divided up to give the daily totals.

I still don't understand why your Weekly total from the Hospital was 22.5 mg and the weekly total from your Cardio was changed to 27.5 unless the schedules you posted were incorrect.

 

[wcasey5]

FYI, dosing is always based on the Weekly Total and then divided up to give the daily totals.

I still don't understand why your Weekly total from the Hospital was 22.5 mg and the weekly total from your Cardio was changed to 27.5 unless the schedules you posted were incorrect.

They increased it because my INR came in at 1.8. However, as you are pointing out, They should have increased my dose by approx 10% to get me in range, so I should have been maybe 25mg total for the week. When I retested after the 27.5 dose, I came in at 2.5. BUT, that was after 3 days of the lower dose, I was probably higher if I tested in the middle of the large dose days. Or at the end of them anyways.

 

[Bina]

Definitely stagger the dosing to make for a more balanced INR.
I find it frightening that your cardio's office condones the "clustered" dosing. That is just nuts.

 

[Ross]

They increased it because my INR came in at 1.8. However, as you are pointing out, They should have increased my dose by approx 10% to get me in range, so I should have been maybe 25mg total for the week. When I retested after the 27.5 dose, I came in at 2.5. BUT, that was after 3 days of the lower dose, I was probably higher if I tested in the middle of the large dose days. Or at the end of them anyways.

That may be so, but the other 2.5mg isn't going to make that big of a difference, so I think your on target.