wcasey5
Well-known member
So, I totally screwed up and missed 2 days of warfarin and my INR is at 1.4. I have to go back and get rechecked on Monday, but is it advisable to let the increased dosage do its work, or get some Lovenox in the interum?
Inr 1.4 !!??
- Thread starter wcasey5
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sorry if I yell....LOVENOX NOW.
When did you miss your warfarin? Were they two days in a row? Is your range 2.0 to 3.0 or 2.5 to 3.5? Also, when you tested?
wcasey5
Well-known member
I missed them on the weekend, my range is between 2.0 and 3.0. 3 weeks ago I was 3.7.
Was this test of l.4 today?
wcasey5
Well-known member
yes, it was today
K
Karlynn
When was it 1.4 and what days have you taken your dose since - Monday, Tues ?
wcasey5
Well-known member
I missed Sat and Sun, and when tested this morning it was 1.4. I took my regular doses mon, tue. I usually take 5mg mon and fri, 2.5mg the rest of the week. So I took 5mg mon, and I actually took 5mg tue. The nurse said I should take 7.5mg today and tommorrow, 5mg on fri, and 2.5 sat and sun, get tested again on mon.
K
Karlynn
So the 1.4 is definitely reflecting your skipped doses. Since you took your dose on Mon and Tues, I'm guessing you're on your way back up and an INR will be higher tomorrow.. Do you home test?
wcasey5
Well-known member
I am in the process of getting a machine, so I don't home test yet.
My doc would have me on Lovenox today, and since I have my own tester, I would be checking again tomorrow morning. Your INR should be rising, but I am not a gambler for even one day.
K
Karlynn
Bottom line - I think it's up to you and what you feel comfortable with. If it were me, I'd see what a test tomorrow holds. I know we're not supposed to test back to back, but I have, in the types of highs and lows incidence, to just make sure the INR is going the way it's supposed to go. If I wasn't on the way back up tomorrow i'd look into Lovenox. But that is just me, please make a decision with what you feel comfortable with.
wcasey5
Well-known member
Unfortunately, living here in the states, health care is not as easy as it was when I lived in Canada. I think I may call and insist on a script! This is scary!
wcasey5
Well-known member
Karlynn thanks, that's good advise. I am leaning towards a lovenox script. Does that stuff last if its not used?
It seems you were probably given sound instructions. It is always risky when your INR drops below range. You should be on your way up now. Lovenox would probably reduce your risk even more.
If your dose was reduced when your INR was 3.7 then I would be more concerned since your INR may have already been below range even without having missed a dose. It wasn't reduced was it?
If your dose was reduced when your INR was 3.7 then I would be more concerned since your INR may have already been below range even without having missed a dose. It wasn't reduced was it?
ALCapshaw2
Well-known member
Another outdated and clueless manager OUT OF CONTROL!
She's trying to use the no-longer-accepted practice of Loading Doses to bring up your INR. It has been shown that tends to lead to the "Roller Coaster Effect" where your INR goes too high and then they will tell you HOLD doses to try to bring it down.
That is like trying to drive at the Speed Limit by Stepping on the GAS and then the BRAKES and hoping to come out somewhere in the middle. IT DOES NOT WORK!
Let's look at your regimine:
Your regular dose comes to 22.5 mg / week
If you take the doses prescribed by that Nurse,
your intake for the week will be 35 mg which just over a 50% increase. YIKES !
The BEST way to get back to normal is to protect yourself with Lovenox Shots (prescription and training required) and resume your Normal Dosing Schedule until you are back in range, testing after 1 week.
'AL Capshaw'
I would be giving myself Lovenox injections in the Walgreen's parking lot by now!!!
I too suggest that you get started on Lovenox today & recheck in a week.
I have a bunch of Lovenox syringes in a bag that I keep on hand for emergencies. I hope my home is never raided, cause next time you all hear from me, it'll be from jail!!!
wcasey5
Well-known member
Good point, I called for the script (had to leave a message) and we will see what happens.
I tried to see how much it would be from my insurance company. HA! They said it interacted with my coumadin so they couldn't give me a price, so I argued with them for 40 minutes. Anyway, I found out it was around $40, on my own. Apparently drugs don't have a price here until you need them.
In any case, I'm headed for the drug store as soon as the anti coagulation clinic calls me back.
ALCapshaw2
Well-known member
You will need to be Instructed on the proper use of Lovenox. It is dosed by Body Weight (100 mg / Kilogram =100 mg for a 220 lb. person)
It needs to be injected every 12 hours.
Lovenox prevents coagulation by a different mechanism than Coumadin and therefore does NOT show up in the INR test. You will take Coumadin AND Lovenox until your INR is in range, then discontinue the Lovenox.
It is injected into the Belly Fat around your Belly Button.
It would be good to have a Nurse show you how to do this.
'AL Capshaw'
It needs to be injected every 12 hours.
Lovenox prevents coagulation by a different mechanism than Coumadin and therefore does NOT show up in the INR test. You will take Coumadin AND Lovenox until your INR is in range, then discontinue the Lovenox.
It is injected into the Belly Fat around your Belly Button.
It would be good to have a Nurse show you how to do this.
'AL Capshaw'
