INR & Doctor Troubles

[Freddie]

No, this is not regarding me, but my SO mom.

She's a new patient on warfarin (about 6 weeks), range is to be 2.0 - 3.0 and testing weekly.
On many meds one that reacts with warfarin - called Crestor.
For the past 3 weeks her INR has been: 3.3, 2.6 and of yesterday 1.6. She only has the 5mg pill - and has been taking the same dosage of 2.5mg for the past 3 weeks. The doctor never called her for the past 2 weeks, not even with her low reading. She claims that her diet hasn't changed.

In order to get her INR back up, what dosage should she take until her next lab draw on Wednesday?
I have a theory, but want to see what you "the smartones" say
I know, I know she should find another doc - lets not go there

Thank - you in advance

 

[Ross]

Something is askew with the results. I'd do nothing at this point until after the next test.

ROSUVASTATIN (in Crestor) may interact with WARFARIN SODIUM (in Coumadin Tablets)

Rosuvastatin may block the breakdown of warfarin by the liver. If this happens, blood levels of warfarin could be increased and this could increase its anticoagulant effect. Warfarin is generally used to prevent your blood from "coagulating" or forming blood clots. When rosuvastatin and warfarin are used at the same time, your blood may be much less likely to clot and this may increase the risk of excessive bleeding. If these drugs are taken together, your doctor may want to monitor you closely when therapy with rosuvastatin is either started or stopped. Blood tests can be used to make sure that you are getting the right amount of warfarin. If you are experiencing problems, it may be necessary to adjust the dose of warfarin. Discuss this potential interaction with your healthcare provider at your next appointment, or sooner if you think you are having problems.

This interaction is well-documented and is considered moderate in severity.

Last Updated: August 2006

 

[Roger Frank]

There are other Statins (Lipitor) that seem to be more warfarin friendly....or so I'm told.

 

[Karlynn]

My cardio wanted to put me on Crestor, but I came home, read the info regarding warfarin and asked to try Lipitor again. I didn't want to mess with a medication that required me to increase my dose.

 

[Freddie]

Something is askew with the results. I'd do nothing at this point until after the next test.

I've read that stress can also cause INR to drop....true or flase?

We may have found the problem if the answer is true: stress does cause INR to drop.

If that is true would her reading drop that much? 2.6 two weeks ago, to 1.6 this past week?

 

[Ross]

I highly doubt it Freddie. I'm thinking more like she missed a dose and forgot about it.

 

[dick0236]

Freddie, I agree with Ross and would do nothing until the next test. Crestor is a statin for cholesterol. I was on it for a few months, a couple years ago, and noticed no change in INR. However, your friend may have a different reaction to Crestor.

I am REALLY in favor of seven day pillboxes, especially if a person in taking several different drugs.

 

[Bina]

If I had a reading of 1.6 I would up my dose for one day anyway.
By next Wednesday she could drop even further.