fluctuation in INR over two weeks inbetween tests

[mac]

Hi all,

Just acouple more inr questions. reading 3weeks ago was 2.8, 2 weeks ago, 2.6, last week 2.4. This is all at 4.5 mg. I am now set up to test every 2 weeks. This past Monday I had the 2.4, well on the Fri. before I had 2 pints of beer and the Sat. before my Monday test I had 2 pints. First thing I thought was my inr on Monday would be around 3 since the week before it was 2.6 and was rather surprised that it was lower. Any input on these readings. Should I asume that these couple pints of beer on Fri and Sat. had no effect on my inr reading. My diet is pretty consistant. We do not eat alot of vit K stuff. My only vise is that I like acouple of pints of good micro brew once in while, as people are aware of from my earlier posts.
Also unless you checked ever day what kind of fluctuation could be expected during the 2 weeks inbetween tests? Acouple pt's up or down, or does it stay pretty consistant? Maybe dumb questions, and maybe I worry to much. I guess you have to believe that if your diet is consistant your numbers will be consistant. It's just reading some of these post with people who's number are all over the place is dishearting. And what's up with taking 5mg on , m,w,f,s, and say 7mg on t,th,sat. to achieve inr goal number, seems strange to me.

Mac
AVR, single by-pass
Carbo medics mechanical
Dr. Suri
Mayo Clinic

 

[Bina]

Your INR readings have been taking a very slow and gentle decline, and that is very common during post op recovery. As you begin to be more active your body may require a slightly higher dose of Coumadin to keep you in your INR range. The couple of beers wouldn't have much to do with anything.
We usually keep track of dosing on a weekly basis, and adjust that as needed.

 

[Bina]

Here is what I would do to bump up your dosing:
You have been taking 4.5 daily for the past 7 days = 31.5 mg weekly
A 5 % increase is a good place to start (1.5 mg over the week)
So take the following:
Saturday 5 mg
Sunday 4.5
Monday 5
Tuesday 4.5
Wednesday 5
Thursday 4.5
Friday 4.5

 

[Philip B]

Fluctuation

Fluctuation

Other than a gradual drop over the past three weeks, you're not really fluctuating that much. I tend to see more dramatic fluctuations week to week. I have a tough time getting on much of a regular schedule with my exercise program during the winter. Metabolic rate tends to be the driving force in my INR. Alcohol and food seems to have little impact.

When I find myself at the low end of my range (2.5), I usually increase my dosage from 5 mg to 7.5 mg for a day or two during the course of a week. This typically brings me up slowly.

During the winter months, I often check my INR twice weekly. Checking more often helps me tweak my dosage. Personally, a check once every two weeks during the winter wouldn't work well for me, but that's just me.

-Philip

 

[dick0236]

Hi all,

Just acouple more inr questions. reading 3weeks ago was 2.8, 2 weeks ago, 2.6, last week 2.4. This is all at 4.5 mg. Any input on these........ And what's up with taking 5mg on , m,w,f,s, and say 7mg on t,th,sat. to achieve inr goal number, seems strange to me.

The 2.8, 2.6 and 2.4 may be just normal test tolerances and not due to any food, drink or other source. If your INR range is 2.0-3.0, I wouldn't worry since all three readings are solidly in range. It seems that you may be trending down 2.8 to 2.6 to 2.4. If you continue trending down you might consider increasing you dose a little. A few pints probably is not causing the INR "twitches".

I'm not sure I understand your other question.
Taking 5mg/four days and alternating 7 mg/three days is just one way to take 41mg/wk. You take whatever mgs you need to stay in "your" INR range and it usually best to take reasonably level doses.

 

[Ross]

I would follow Bina's plan since your apparently trending down, but other then that, your INR isn't fluctuating. This is how INR is. All newbies expect it to be a solid single number all the time and that is not how it works. Most of us are happy so long as it's between 2.0 and 4.0.