Frequency of INR testing

[Jeff Summers]

Hello. Looking for some personal info. I have been very regular regarding my ProTime/Inr levels. I get checked every 8 wks, 2.5-3.5 every time, for over 2 years. I forgot to go get checked last month, so it has been 12 wks, I call the office to let them know that I am coming in for a test, they call back and say the Dr wants to go to 6 month increments. I think that is a little long, and told them that I would be comfortable with 3 months. Any body out there go longer than 3 months? Thanks!

 

[Ross]

I would be uncomfortable with more then 30 days, no way would I go for more then 60.

 

[bvdr]

Jeff,

Absolutely not! I know of some who go every 5 weeks but 5+ months?
I'm glad your INR is so steady but it is still a powerful drug that needs to be monitored much more closely than that.

 

[Ross]

they call back and say the Dr wants to go to 6 month increments.

What do you think Al, is this one a wall of shame candidate?

 

[Rich]

Jeff,
My INR was steady as a rock for seven and a half years.
Then out of nowhere it dropped really low.
It turned out to be caused by heavily increased physical activity following my retirement.
If I hadn't been getting checked monthly I would have not known about this potentially dangerous situation.
For that many years being very consistent I often questioned why I had to do this monthly, I thought I could go every two or three months.
Now I understand why and what devastating things could have happened to me.
Things can change in your lifestyle and you may not be aware of the problems it can cause, I sure wasn't.

Rich

 

[Johnny Stephens]

Every 4 weeks is where I'm told I'll be at for good (barring any new developments in anticoagulation).

3 months, in my opinion, allows too much time for too many variables to change. What is driving this push to stretch out the appointments?

 

[Guest]

Jeff,
The standard of care is approximately monthly intervals between checks.

If something does cause your INR to get out of range, there are two factors that come into play. How far out of range and how long it is out. Six months is asking for trouble.

I have some people that I check every two weeks and some that go every two months. But deviations from the standard of care need to have good reasons.

If you had a fatal mishap caused by warfarin and your next of kin decided to file a legal action, the doctor would be in an indefensible position.

 

[Christina]

INR testing frequency..

INR testing frequency..

Hi Jeff,

I hometest and test weekly or at times bi-weekly, but NEVER go longer than that. I don't care what my doctor says. I call him once a month but for my own sanity I test once a week. Once a month would scare me, and your doc wants it every 6 months? CRAZY!! You tell him I said so! Anything can happen and a stroke or blood clot isn't fun. It could be fatal and it only has to happen once.

 

[McCln]

Jeff

Jeff

I am with the most of the people here, once a month unless there is a low number, then every two or three weeks till normal number. Every three months is too long and every six months is way too long. You have to be regulated regularly for the warafin(coumadin). Please talk to your cardio again. If he says every six months, change doctors. This is no joke. We care and we wish you luck anyway. Take care and be good.

Caroline
09-13-01
Aortic valve replacement
St. Jude's valve

 

[Karlynn]

I agree, this doctor doesn't know about Coumadin management. Once a month if you're stable. I test at least twice a month. I used to be very unstable, but now have been fairly stable.

There are so many things that can affect your INR. Antibiotics is a huge one. You should always get your INR prior to starting antibiotics and then test frequently while on them and for a few weeks after. I can just about guarantee you that you will need to have your Coumadin level adjusted during antibiotic therapy.

 

[Gemma]

Hi Jeff,
My boyfriend Jim had his AVR 4 months ago and after having his INR tested every 4 weeks, they've now put him onto 6-weekly intervals as he's been in range so far. However, he's getting a Coaguchek monitor so he can test himself at home in between to keep an eye on things. We're going into the anti-coag clinic when he gets it to check the results are the same, see how often he needs to go for venous tests once he starts home-testing, that kind of thing. I read somewhere recently that sometimes patients in the UK go 12-14 weeks between INR tests in some places, but I'm not sure Jim would be comfortable with that.
Karlynn - regarding antibiotics, Jim had some for a week in January, and his GP reduced his dosage from 7mg to 6mg daily for the time he was on antibiotics - worked fine,he stayed in range (he was still being tested more frequently then). However, we recently found out the anti-coag clinic (separate entity from the GP's surgery) don't alter warfarin dosage for antibiotics - they prefer to just keep an eye on it and see how it goes. Go figure! - although they've managed Jim's INR and warfarin really well so far, I get the feeling maybe they're not telling people stuff about things like food with Vitamin K in, and what other things can cause fluctuations in INR. Oh well, just thought I'd share!!
Gemma.

 

[MarkU]

My INR has been rock-solid for the past two years and I normally get tested every 6-8 weeks. I think 8 weeks is about as long as I would ever want to go.
At the same time, I do make a point to get tested more frequently if I do something to change my normal routine, like before and after any vacation trips.
I also got tested every couple of weeks when I was training hard for my first triathlon earlier this year just to make sure I wasn't doing anything to get out of range.
Actually, I think the key is the two glasses of Merlot with dinner every night..

MarkU

 

[hensylee]

Brother's cardio ordered 'monthly'........

 

[Ross]

Actually, I think the key is the two glasses of Merlot with dinner every night..

MarkU

Tisk, Tisk, Tisk.

 

[MarkU]

Tisk, Tisk, Tisk.

Remember, consistency is the key...

 

[Rain]

You gotta be kidding....

You gotta be kidding....

My INR went sky high just reading this thread.....

 

[terry40]

I agree with the rest!

I agree with the rest!

I get mine done every 4 weeks, I've been in therapeutic range for almost a year now.

I still get very anxious, until I get the results, I could not wait 6 months.

 

[Marty]

Know Yourself! Nothing in Excess!

Know Yourself! Nothing in Excess!

The evidence has been out there for some time now that self testers and self dosers stay in therapeutic range more consistently than patients using central labs.
Why? They test more frequently because it is convenient and cheaper. They learn how to adjust dose and do not have to wait for a call from a doctors office telling them what to do. The Oracle of Delphi said "Know Yourself" and "Nothing in Excess". Not bad advice for warfarin patients.

 

[Sierra Bob]

Testing Frequency

Testing Frequency

Since Medicare will pay for (and consequently requires) home testing on a weekly basis for individuals on Medicare with mechanical valves, I assume there must be a medical reason for this frequency.