High Dose Coumadin - What's the Limit?

[Toronto Guy]

Hello and Happy New Year everyone

This is my inaugural post on VR.com

What a great site!

I have been lurking since mid-summer - that's when I heard the dreaded words from my cardio "you are leaking" and another valve job loomed ahead

Discovering this site helped me pre-surgery AND post-surgery

It's been a fast 11 weeks since my AVR - thank G-d my recovery has been nothing short of amazing (perhaps 2 previous heart surgeries helped prepare me)

Just returned from a 15 state, 4200 mile road trip - a scenic road test for my new SJM HP valve!

I do however miss my pig valve (it lasted a care-free, no maintenance, 13 years, no complaints)

My INR peaked at 3.5 in mid- December (on a dose of 10 mg/day), and quickly slipped to 1.5.

On Jan 6 the daily dose increased to 12.5 and yesterday's blood test revealed the INR is stuck at 1.5 (blood tested 2x week)

I also take a low dose aspirin daily - no other meds

I eat lots of salads and nuts

My GP today suggested moving coumadin up to 15mg/day

Are there any other high dose coumadin poppers out there?

Are there any risks associated with high doses of coumadin?

Thanks in advance for your inputs

All comments are appreciated

Phil

 

[Guest]

15 mg/ day is higher than normal but certainly not unusual. Some people I know who do warfarin management had a guy on 100 mg/day. The largest dose that has ever been reliably verified was 660 mg/day. (66 X 10 mg per day).

One thing to keep in mind, it takes 3 to 5 days before a dose of warfarin exerts its full effects, so testing two times per week can lead to misjudgments. Dose increases need to be based on what you took over the past 7 days, not just since the last dosage change.

It is normal for your INR to drop when you starte feeling better, eating better and get more active.

 

[Christina]

Coumadin dosage.

Coumadin dosage.

Hi Phil,

I am a fast Coumadin metabolizer and take 23-24 on alternate days right now. During the hot summer months I have been known to even take more.
I eat what I want and adjust the Coumadin accordingly. I do my own dosing and have been home testing for 4 years. I have seen little or no side effects.
The doctors didn't know rigth after surgery that I was a fast metabolizer and kept the dosage low, and even supplemented me with Lovenox to get the INR to go up.
I got a blood clot and after 11 days the surgery needed to be redone. They replaced the mechanical valve that was put in 11 days previously with a shiny new St. Jude's.
I have been fine.

PS.. Toronto guy.. I lived in Kitchener-Waterloo, Cambridge close to 8 years. I loved going to Toronto. Nice clean city. Hated the cold though, so now I live in the SW of the US.
Stay well my friend.

 

[M&M]

Hi Toronto Guy, When you say you eat lots of salads and nuts - do nuts have Vitamin K ?

Yes this is a great web board - lots and lots of very nice people...

I've been to Toronto and its such a beautiful city.

Marilyn (runner)

 

[Toronto Guy]

Al, Christina and Marilyn

Al, Christina and Marilyn

Hello again

Thanks for your replies

Al - you have dazzled me with your warfarin knowhow since joining this joint in early summer.
Then along came my valve job 11 weeks ago, and your stock
went sky high. Wow.

Christina - you walked away from frigid winters, slush-filled shoes, and scraping ice off your frozen windshield? Hmmm...
Nice to meet another hi-doser and glad to read that your life got boring after that 11 day spin.
How do you keep your valve shiny?
What do you use for home testing?

Marilyn - Nuts do contain Vitamin K - and I'd be nuts not to defer to Al Lodwick on the nutty particulars. And isn't it amazing that few of us here had ANY interest in Vitamin K before that clicking sound started

Be well EVERYONE

Phil