Inr 6.2

[KathyH]

Yesterday my Inr was 6.2, which is the highest it have ever been. I was told to hold coumadin yesterday and today. I normally take 5mg per day for the last 4months, I have been trying to figure out what I did different. I certainly see holding the dose yesterday, but I would think it would be better to take something today, just take a lesser dose for, say today and day after tomorrow or something. I wondered if anyone had any thoughts on this.Thanks
Kathy H

 

[Ross]

I agree with you, holding two is probably going to cause trouble and if you've been stable all this time, I'd question the accuracy of the test.

 

[Karlynn]

The info I have for INR target range of 2.0 - 3.0.
"INR greater than 4.0 hold no to one dose and decrease weekly dose by 10 - 20 %."

Did you take an antibiotic? Or any new OTC or Rx? Were you exercising regularly and then stop? It's been my experience that any time I have a crazy INR, it's most always do to a change I can eventually remember - emphasis on the word eventually.

If I were to withhold 2 doses, I'd rebound into the basement.

 

[Barry]

FYI, I've found that brand-name Coumadin is less likely than generic Warfarin to produce INR's that bounce around.

 

[bvdr]

Kathy, don't stress over it. I'm with Ross and Karlynn. My INR sure bottoms out when I have to hold even one dose. I picture it as standing in a little rowboat. If it starts tipping in one direction I sure don't want to step abruptly onto the other side. It sounds like you are doing very well with your anti-coagulation.

 

[Guest]

A dose of 5 mg per day and and INR of 6.2 puts you right at the point where it is impossible to predict whether it is better to hold one dose or two doses. If I were managing your warfarin, I'd probably have you hold one dose on the basis of "it's better to be a little high than too low." If the person were very nervous about being too high, I could be talked into holding two doses. Neither choice is likely to cause a disaster.

 

[KathyH]

Karalyn, I bet you hit it. I was on vacation so I didn't ride my stationary bike for a half hour every day! I did some walking and rode my bike a few days but to be honest, I did slack off on my exercise. (I was on vacation )
Ross, I did have the nurse check it twice . They use the coagucheck. Thanks for the input, I feel better knowing what I would have done to cause it to go high. At first I wondered if it was because I had 2 glasses of wine on Sunday, but I do have usually only 1 glass of wine when I go out, but usually I test on Wed so I would not have drank the day before the test. Maybe I should just start drinking every day but then that won't be good for my diabetes medication. Shucks!
Kathy H

 

[Guest]

The key to good warfarin therapy is following a routine. The idea of a vacation is to break the routine. Therefore, the idea of a vacation is to lose control of your warfarin.

The easiest people to manage are those who are those whose mental capacity just barely allows them to live alone. They get up every moring and eat their breakfast, wash the dish, watch TV until lunch, eat lunch ... Their routine never varies so their INR rarely varies.

The hardest people to manage are the homeless. They don't know what the next 5 minutes will bring, where the next meal will come from etc.

 

[Barry]

Maybe I should just start drinking every day but then that won't be good for my diabetes medication. Shucks!
Kathy H

Have you considered street drugs? (joke, joke)

Actually, it's my understanding that few street drugs interact with Warfarin. But, as a general rule, white powders are not your friends whether you're on Warfarin or not.

 

[KathyH]

Rachael,
I have read that the more you exercise, the faster you metabolize your coumadin and that is what causes your INR to go up.
Kathy H

 

[Guest]

I got a referral yesterday on a patient who takes the "date rape" drug for fibromyalgia.

 

[Karlynn]

Rachael,
I have read that the more you exercise, the faster you metabolize your coumadin and that is what causes your INR to go up.
Kathy H

It's my understanding is that it's the opposite. The INR goes down with fast metabolism. That's the way it works for me. If I miss a week or two of Curves, my INR is always higher because I'm dosed for a lifestyle that includes working out.

 

[Guest]

Karlynn nailed it.

The more warfarin in your body the higher the INR. You probably had it right in your brain, Kathy, but it came out on the computer backwards.

Maybe somebody can name the evil god that causes this.

 

[ALCapshaw2]

YEP,

WHACKED SHIN,

STOPPED walking Dog daily,

INR went UP.

'AL Capshaw'

 

[Karlynn]

Al,
Keep meaning to mention that I love your new avatar!!!

 

[Guest]

Thanks. They both have mechanical valves but the # of spaces under the avatar would not allow that much info. The older girl was the first child I ever managed. I saw her in the grocery store one time and she ran up and threw her arms around me. My wife's reaction, "Do I want to know what this is all about?"