Dosing help please

[RobinH]

Hi All..I'm fairly new to home testing and I've got a dosing question. My INR last Friday was 2.6. Today it was 4.1. My range is 2.5 - 3.5. I suspect the large increase was due to the fact that I was sick all week with a bad cold and didn't work out at all. Normally, I'm in the gym 5-6 days a week.

My normal dosing schedule is 5 mg on Tues, Thurs, Sat. and Sunday and 7.5 mg on Mon, Wed and Friday for a total of 42.5 mg/week. My doctor wants me to hold my dose of 7.5 mg today and then resume my regular dosing schedule. This seems like a huge drop to me because I'm feeling better and resumed my regular exercise schedule today. I hate to question my doctor's judgment but it does seem a little extreme. What do you think??

 

[Karlynn]

I wouldn't do anything and test again in a week. (or 5 days if you're uncomfortable waiting that long.) If you were sick, it makes sense your INR was higher. I'd be afraid that lower your dose now will take you lower than you want. If you are feeling well again and back to your usual activities the INR will correct.

 

[Blanche]

I agree with Karlynn

I agree with Karlynn

My husband's range is 3.0 to 4.0 because of other medical problems. His INR has been 4.1 many times, with no problems at all.

Blanche

 

[Bina]

Do NOT hold any dose for an INR of 4.1 that was not otherwise climbing......Please.

 

[Karlynn]

Holy smokes - I didn't read the hold instructions by your doctor. NO WAY!!!!!! Sorry - but he's nuts.

Your range is 2.5 - 3.5. Your INR was 4.1 after being sick, probably not eating as much, not exercising and your metabolism slowed. You didn't go very high at all, all things considered. Most of us like to stay in the upper end of our range. I never make any changes for a 4 INR (and my range is the same as yours).

I should say that I'm not a trained medical expert. But I am speaking from over 17 years of Coumadin use and learning how my body reacts to dosage changes.

 

[Tbone]

It is always better to be over your "target range" not under!

 

[Ross]

I would do nothing! Wait for the next test result. I agree that it's because you've been inactive and not up to par. I'm almost certain it will fall back into range once you start your NORMAL routine again. No way should you hold for 4.1. If your going to hold anything, hold only 2.5mg!

I'm not a medical professional either, just someone who's self dosed for the last 7 years.

 

[RobinH]

Thanks everyone for your wise responses. I decided not to hold anything and continue with my regular dosage. I'll retest again in a week. I have a feeling I'll be back in range again!

It's so great to have this forum as a resource for a newbie valver like me! Thanks!