Ever Missed A Dose?

[Shari]

Has anyone ever missed taking a dose of their coumadin? What did you do? Did you double dose (e.g., take two doses within one day)?

I constantly remind my husband to take his medicine...dare I say Nag???!!!! LOL! Anyhow, his meds are broken down into taking them 2x/day. He always takes his coumadin, aspirin, and lopressor (2x/day) at night. Two weeks ago, he missed a dose of coumadin. He also has not been good at taking his evening medicine at a consistent time. (I'm sure this is contributing to his low INR.) He always does well with his morning medicine, but the evening medicine is a different story. This past week he has been really great at taking his evening meds. I'm worried that when he returns back to work full-time (his doctor still hasn't released him to go back to work) that he's going to get all messed up again.

Does anyone take coumadin in the morning? The nurses at the hospital said taking it in the evening is better. I'm just wondering if I should switch it around so he takes basically all his meds in the morning except his second dose of lopressor.

 

[Nancy]

Hi Shari-

My husband Joe has been on Coumadin for 24 years. He always takes it at night before dinner, and as long as I can remember, has never missed a dose. You have to read the riot act to your husband. He has to get serious about taking his meds., the consequences aren't good when you have heart problems. And that applies to all his meds. not just Coumadin.

This is mommie speaking, be a good boy, now.

 

[hensylee]

Since coumadin dosages are especially measured for the individual, your husband should never miss a dose. That just asks for trouble.

 

[Perrster]

No No No!

No No No!

Whoa, Shari's husband! Don't ever double up the Coumadin if you miss a dose! The directions from the manufacturer (Dupont) even say not to do this. Have you checked out the Coumadin link? It's on the vr.com front page. Go there and get some good answers to FAQ's.

Don't worry too much if you miss taking a dose. Just stay on course. Whatever the next day's prescribed dose is, take only that one and don't substitutute. My Coumadin Clinic nurse is so good she has memorized my 2.5/5.0 schedule. I don't understand why my doses are different every other day, but I fully trust her expertise on this. Just recently she had me adjust only one day's worth because I had a fairly large bruise (car door bit me!) then she told me to go back on course the next day.

If you haven't already done this, get two of those large plastic pill boxes at the pharmacy and keep a week's worth of meds in them. I organize two boxes for AM and PM intake. I take my PM (including Coumadin) just prior to leaving the office, so I don' t have to think about it in the evening.

Us "heart-healthy" folks seem to have no way of getting around the massive amount of medications we need to take. A good routine and schticking to it makes a difference.

Regards.

 

[DickV]

I agree with Perry. Double doses can really cause problems. I have a small alarm clock in the den that goes off every evening at 8:00 pm. and at that time I down the meds.

I also have a few spare doses in each car and my wife carries one in her purse.

Dick
Hooked on Coumadin

 

[RobThatsMe]

Hi Shari,

I agree with Dick and Perry. Don't ever double up on a dose. I also have a pill box with my weekly cocktails. If you have concerns.. call your doctor, inform him, and ask for his recommendation.

As for when is the best time to take Coumadin. I strongly feel that evening is the best time. That way, when it is at it's strongest level, you are sleeping. I am sure this is very minor since the effect of Coumadin is gradual, but I still think there is some truth to it. But most importantly, If you go to the doctors, or home test your INR, and an adjustment in dosage needs to be made, you can adjust that day.. because you have not taken your evening dosage yet. If you already took your dose in the morning... you will have to wait until the following day to adjust.

Rob

 

[CristiD]

Hi Shari,

Just a comment from an SO. From day one Rob has kept his meds in a daily dose pill box. To my knowledge, once he got into a routine he has not missed a dose and with the daily dose box, if he is in doubt, it's easy to check. I know your husband travels also and it would be hard for you to "police" his doses so it is important that he get into a routine, relate taking his meds with another activity he does each and every day. With meals seems the easiest to remember.

Cristi (wife of Robthatsme)

 

[hensylee]

I didn't mean he should double up; I meant he should NOT miss a dose on time-that sort of "never miss a dose". Brother is on it and think he takes his at night, too.

 

[Hank]

Missed Dosage

Missed Dosage

I have a personal rule that I can't go to bed at night until I take my coumadin. Somehow that always reminds me. When I get tired, and head for bed with the last thought of "do I have anything else to do before I go to bed" I always think of it and take it then.

It depends on when you discover that you missed your dose. Personally, if it is less hours to my next dose then it is from the dose I missed, I won't take it. But if I wake up first thing in the morning and remember then, I will take the dose and eat a lot of salad or something that day.

But truth is, in the 2 and a half years since my surgery, I have only missed 3 nights.

 

[cookie]

missed dose

missed dose

Hi Shari,
In the beginning I missed a couple of doses and panicked! They never had me double up. Just get on track the next day. I also keep a pill box with my PM meds. I know for sure that I will be going to bed every nite so that is when I take my coumadin. It's usually the same time every nite being the elderly people that my husband & I have turned into! LOL I tried to take it at supper time but half the time we would go out to eat or grab a quick bite on the way from work and I would forget. So the pillbox has worked out wonderful. Haven't missed a dose since I started it and it's also easy to keep track of your pills taken. Good luck!