INR 2.46 - Should I worry about this?

[INRtest]

I just got my lab results & wonder what to do. My INR has held very steady, Oct.: 2.55; Nov: ?; Dec: 3.22; January: 2.87; Yesterday: 2.46

I take 7.5 mg (x 7 days = 52.50 week) Coumadin. I haven't found any information on how to adjust my dosage to meet this small deficit. Funny thing, I have been to the gym less the past several weeks than normal, have had about my normal alcohol intake (1 - 2 drinks / week).

My Lodwick Publishing dosage chart indicates a weekly increase of 10%-15% for INR of 2.1 - 2.4. If I'm currently taking 52.50 mg/week, do I increase by 5 mg/week????

I guess I have to pick up a prescription for 1 mg tabs.

 

[Old clicker]

What range are you to be in? I am to be between 2 and 3, for me its perfect. In my opinion i wouldn't change anything. it will be interesting to see what others would do.

 

[Karlynn]

I wouldn't change anything either - just test in a week or two. I'm assuming your range is 2.5 - 3.5?

 

[catwoman]

Jess:

I wouldn't be worrying about it.
It looks like you test once a month, so it's hard to tell if you're on a down swing or have been down and are on an up swing.

Is the only size of tabs you have 7.5's?
I take 6.5 daily and keep 10mg, 2mg and 1mg tabs on hand. I halve them to get 6.5mg. If I need to bump up my dosage, I already have the tabs to do so, and if I need to reduce it, I can.

 

[ccrawford]

Jess - Several questions: are you supposed to be self dosing, or does your clinic usually do this ? If you are doing it yourself, make sure you get comfortable with the contents of Al's book, and keep learning from this web site. Do you have several sizes of pills? If so, then it makes it easier to change a dose. The 10% change, can apply to either the weekly dose or the daily dose. It usually makes sense to compute it on the weekly dose, then figure our what combination of daily doses it takes to get there. I use 5mg and 1mg along with a pill splitter and this works well for me.

 

[Ross]

Jess personally I would not change a thing just yet. See what the next test says and if still low, then maybe bump 10% up, but the dose your on seems to be your sweet spot. Give it one more cycle and see.

 

[Guest]

The PT/INR is not an exact science. Reporting to the second decimal is meaningless. Your INR is trending down as you get healthier. This is not unusual. You will probably go lower yet on the next test. The idea on my algorithms is to give a range where dosage changes are likely to be acceptable. If all you have is 7.5 mg tablets, I'd go up by one tablet per week (7.5 mg) To do this take 1.5 tablets one day and then again 2 or 3 days later take the same dose. Continue with 1 tablet all the rest of the days until you get back to the day where you took 1.5 and repeat this. 7.5 divided by 52.5 is a 14.3% increase -- quite acceptable for the level where you are.

 

[INRtest]

Thank you all for your prompt responses. Al, I'll take an extra 1/2 pill tonight & in a few days, pick up some 1's & 2's for future use & return to the lab for a re-check in about 3 weeks.

I have been adjusting my own dosage with approval from my cardio -- but I'm actually teaching her about dosing (as I learn from this site). I would have thought that my dosage would be decreasing as I age, but I've only owned my valve (or it, me) for 1 1/2 yrs.

 

[ccrawford]

Jess - its pretty rare to see self dosers in the US, but not a big deal if you continue to do your homework. Another tip - Any time you start a new drug regimen (prescription or non) be sure to check for Coumadin interactions on one of the web sites, and then do a test about five to seven days after you start the new drug. Most of the time I've been out of range has been because of a new drug. Not everyone is affected the same. I.e. I know by experience that if I start a Tylenol regimen of 1500 mg/day, my INR will roughly double in about four days.