How much warfarin (Coumadin) do you take?

[hayden]

To my mind, a 7 day pill box is the BEST way to keep the daily doses straight.

FWIW, my oblong shaped TARO Generic Warfarin tablets scored in the middle are MUCH easier to break in half than the round Coumadin tablets. AND, my INR appears to be equally stable at MUCH lower cost.

'AL Capshaw'

4 per day except on Monday and Friday when I take 5MG

 

[Granbonny]

Alcap

Alcap

I agree. with my Barr warfarin....when I held for 1 day last year for 2 teeth extractions...it was so easy to tweak my warfarin tabs. They are so fragile..soft..I just took a bit of a bite. and tweaked my INR back up slowly...Only took 3 days to be back in range. Tweaking Bonnie

 

[Toronto Guy]

Lets find out how much the average valver takes.

Hi Al

There's more in the 10mg + than I expected

It's still a small sample

Can the poll be made more precise so 10+ is better delineated?

Thnaks in advance

 

[Guest]

There should have been a peak around 5 mg. With so many people voting 7.5 or 10 mg, I think that we have a bias in that those who take the smaller doses feel like they are not "winners" so they didn't vote.

If we were getting a good sample, it is unlikely that we would have even 1 or 2 people out of 44 at the 7.5 to 10 mg range. So I'm pretty sure that no matter what we do, the sample will be biased.

 

[Ross]

I hope you wrong, but it does sort of indicate that way huh?

 

[ALCapshaw2]

With so many of us alternating doses to get the desired 'average', I think it might be better (mathematically) to use Total Weekly Dose as the standard of comparison instead of standard tablet doses.

'AL Capshaw'

 

[csutherland]

Jerry's on 7.5mg every day except 5.0mg on Wed & Sat. That has stayed stable for well over a year now. Because of a new drug benefit thing, he recently was switched from Warfarin to Coumadin. He was on Coumadin for about 7-10 days before his last check and it was still in range. Actually I like Warfarin better for breaking in two. The Coumadin requires a cutter because it's round, vs oblong for Warfarin.

 

[Don Giaquinto]

Don Giaquinto

Don Giaquinto

I was just switched from talking 5mg a day to 2.5mg one day and 5mg the next and so on.

I had a spike in my INR 2 days before Easter. It went to 7.8. I was told to go to the hospital E.R. By then it was 4.6 {24Hrs. w/o a pill} then I was told no dosage till Monday. By Monday PM it was down to 2.5 INR.

I am just shy of 5 weeks post op and at some point in my life I hope to get back to the active life style I had. I have come to understand from this web sight that excerise will cause a drop in the INR. I have also found in this sight that there are home INR testing kits that my insurance might cover.

Given the potential for a flucuating INR, a home test kit is a must apparently.

Don G :}

 

[catwoman]

Right now I'm taking 6mgX7. I may be adjusting it when I test this week.
The only other med I take fairly regularly is Extra Strength Tylenol (sometimes PM version) for an upper back problem I've been experiencing. No BP or statin drugs.

A thought came up while reading the above responses: What an individual takes doesn't mean much without knowing:

1. How active that person is. Is he/she a regular jogger, bicyclist, swimmer, etc.? These people will metabolize warfarin more quickly and require a higher dose.

2. What diet that person eats. Does he/she love broccoli, mustard greens, cole slaw, lots of green salads -- or does he/she forgo the stuff because of concern or dislike for the stuff?

3. What the person's age is or how far out from surgery he/she is. Supposedly, people 65+ may be more sensitive to warfarin, thus require less, and the farther you are post-op, the more active you are (see #1).

4. What other Rx & OTC meds/herbal preparations the person is on/uses. Some of these will intensify warfarin's effects, others decrease.

And of course, some people can be more sensitive to warfarin than others, regardless of their age.

Just my $0.02 worth...

 

[McCln]

Just temprorary on 6mg till my next INR next monday. Usually it is 5 mg. Mon, Wed Fri. 6 1/2 the rest of the week. Had to get 1 mg. since had the 5mg. already. Be glad when back to normal. Had to take antiobotic for infection that spiked it up a bit, 3.8. At least, they change the dose and have me back two weeks later, to give time to adjust. I will let you know monday how I do.

 

[Barry]

I was surprised to see that 7.5 is towards the upper limit - that's what I'm currently taking every day except Fridays. But I've got a mechanical mitral, which, from what I've read at these forums, apparantly calls for a somewhat higher INR than other stuff.

 

[Arpy]

Alternating Dosage

Alternating Dosage

I am on alternating 8mg / 9mg (Brand Name of "Marevan" here in Australlia)which seems to be doing the desired effect (2.0 - 2.5 INR). Lab tests at variable timing at this point in time as its still bouncing around a bit but slowly stabilising. Last lab test yesterday at 3.1.
Doing lots of exercise now though which I believe increases the dosage requirements.

Correct me if Im wrong but the alternating methdology is a better way of getting the total weekly dosage than trying to spluit tablets where you cant be guaranteed that each half pill has half the active ingredient. ie: pills are not necessarily homogenous throughout...

 

[Gemma]

I held off voting until the results of Jim's INR test this week, but his dosage didn't need changing so he's still on 9mg daily. Sorry Al & Ross, that's one more for the 10+ group!!
Maybe you need another poll - how many warfarin users are active and like their greens? May explain the high numbers...

 

[Guest]

Probably 90% of my patients split tablets. In the US many people make significant outlays of money for prescriptions. Most hate to buy another strength of something that they already have. I figure why pay twice for something that they already have an alternative to. The daily dose is not so significant as the weekly dose. If you only break one tablet at a time you get the same amount over a week. Even if you broke many tablets and the sizes were uneven, it would make little difference. If you take 8 mg per day (56 mg/wk) and uneven breaks caused you to get 54 mg/wk could you measure the difference. Maybe, but you would also have to determine the exact vitamin K content of your food, eat at precisely the same minute, exercise at the same intensity for the same number of seconds etc etc etc. Bottom line - there are too many variables to base your life on one rule.

If you live ina country where you do not directly pay for prescriptions, you still have the problem of duplicates ultimately costing you more money because the expenses come out of your income in the form of higher taxes.

 

[Gemma]

Probably 90% of my patients split tablets. In the US many people make significant outlays of money for prescriptions. Most hate to buy another strength of something that they already have. I figure why pay twice for something that they already have an alternative to.
If you live ina country where you do not directly pay for prescriptions, you still have the problem of duplicates ultimately costing you more money because the expenses come out of your income in the form of higher taxes.

In the UK, where we pay a set fee for each prescription item (taxes make up the shortfall in cost), warfarin is counted as one item, regardless of how many strengths of pills you get.
It's unfair that you have to pay extra just because you happen to need a dosage which can't be achieved from one strength of pill. I imagine the reason warfarin counts as one item over here is in part to avoid people who need it not taking it because of money issues - cheaper in the long run for the NHS to cover the extra drug fees than having to pay hospitals to treat them for a stroke.

 

[Guest]

That sounds like a good plan.

 

[Gemma]

Yes, but it works the other way too - Jim spent almost a year getting 28-day packs of ramipril, only to discover he could've actually been getting 2 packs at a time on the one prescription at the same price!
THEN we discovered you can buy a pre-pay certificate for the whole year, which costs about the same as 13 prescriptions, so if you need more than that a year it's cheaper in the long run.
You live and learn