INR too high?

[katiewintle]

Wanted some information if anyone knows the answer.

What happens if your INR is too high? What do you have to do to lower it? Mine was 4.9 the Friday before last and 3.9 last Friday. I should be between 3 and 4, ideally 3.5.

Thanks in advance for any answers

Katie
xx

 

[Bina]

It really depends on how high it is...don't freak out in advance.

 

[Ross]

The question is, what is your INR now and what dose are you on?

 

[katiewintle]

Going tomorrow for my INR test, last Friday it was 3.9. I am on 9mg Mondays and Thursdays and 8mg Tues, Wed, Fri, Sat and Sun.

 

[Ross]

8X5 days and 7X2 days, if it's still 3.9 to 4.0.

http://www.pace-med-apps.com/CoumCalc.htm

 

[katiewintle]

Well been today and my INR is 3.5, bang on target. Am on 9mg Mon and Thurs and 8mg the other days.

 

[Ross]

If it keeps rising out of range by a tiny bit, you can either drop 5% for the week or just let it ride and do nothing.

 

[Luckyguy17]

re the INR, just realized i am likely heading for disastrous INR reading next Tuesday, unless something wrong with my math

Starting INR Tuesday 5/18 INR was 1.2
Since Wednesday 5/19 Coumadin dose is 5mg
slow climb till 5/22, where INR = 1.6

3 more doses of 5mg

results 5/25 INR = 2.5, doctor recommends staying on course till 6/1 (i only have Coumadin 5mg tablets)

Seems to me i will likely have an INR of 4+ by next Tuesday 6/1, does that make sense for you experienced dosers?

is an INR of 4 to 5 considered as dangerous for a few days?

thx Gil

 

[Ross]

re the INR, just realized i am likely heading for disastrous INR reading next Tuesday, unless something wrong with my math

Starting INR Tuesday 5/18 INR was 1.2
Since Wednesday 5/19 Coumadin dose is 5mg
slow climb till 5/22, where INR = 1.6

3 more doses of 5mg

results 5/25 INR = 2.5, doctor recommends staying on course till 6/1 (i only have Coumadin 5mg tablets)

Seems to me i will likely have an INR of 4+ by next Tuesday 6/1, does that make sense for you experienced dosers?

is an INR of 4 to 5 considered as dangerous for a few days?

thx Gil

Nope, your doc seems to be doing the right thing. Keep it up with 5mg for a week and then test to see where your at. You'll likely be dead on.

4 or 5 is nothing to freak about. You have to be really high, say 10 or better to be in real danger.

It takes 3 days for a dose to show in the INR test. You may be a little high, but it won't be high enough to freak over.

 

[dick0236]

re the INR, just realized i am likely heading for disastrous INR reading next Tuesday, unless something wrong with my math

Starting INR Tuesday 5/18 INR was 1.2
Since Wednesday 5/19 Coumadin dose is 5mg
slow climb till 5/22, where INR = 1.6

3 more doses of 5mg

results 5/25 INR = 2.5, doctor recommends staying on course till 6/1 (i only have Coumadin 5mg tablets)

Seems to me i will likely have an INR of 4+ by next Tuesday 6/1, does that make sense for you experienced dosers?

is an INR of 4 to 5 considered as dangerous for a few days?

thx Gil

From what you have posted here, I would not worry. You seem to be moving up progressively My gut tells me that your test on 6/1 should put you in the mid 3s. No, an INR of 4 to 5 is not dangerous, but for me, if it goes above 4 I merely stop 1/2 dose(2.5 mg). Works every time:biggrin2::biggrin2:

 

[Luckyguy17]

Thanks Ross and Dick,

reassuring information and will post next week when i get results

thx

Gil

 

[Bina]

Katie, 3.5 is just great.........Gil, it sounds like your INR is moving up decently don't worry.

 

[Gail in Ca]

I never, in 8.5 yrs, had my INR go above 4, and when it was, the doc helped me with my dosage to lower it. Even going to 4 was a one time deal, UNTIL I got bacterial endocarditis. So, to make a long story short, when your INR goes too high like mine did, to 9.3, you are hospitalized and given vit K shots and also some FFP (fresh frozen plasma). Also, I was taken off coumadin totally, and not even given heparin or lovenox, for a few days, until I was stablized.
Really, the best advice is not to worry, because your INR usually stays within range or just a bit above or below. Going bonkers like mine did was a rarity, caused by a bad bacteria. Everyone with a valve replacement should know the symptoms of endocarditis, because many hospital ER's and urgent care docs don't suspect this first. They think you have the flu.
One more point, some say an INR of 5 isn't dangerous. This may be true, but mine was at 6.6 when I had blood in my urine. I was already getting internal bleeding. So, I would be concerned if mine ever was at 5. Also, to say you'd have to be at 10 to have a real problem is nuts. The night after my 6, I had a bad headache which turned out to be a brain bleed. So my INR was between 6 and 9 when this happened. It was found to be 9.3 two days after it was in the 6 range.

 

[Philip B]

Too High?

Too High?

You'll probably find that your INR fluctuates. Managing the fluctuations and changes isn't that tough...Too high...simply reduce your dosage...Too low...increase your dosage.

-Philip

 

[olefin]

During the last 19 years my INR has been over 6 many times. No problem, stopped warfarin for couple days, started back at lower dose and retested in a few days.

I've had blood in my urine two different times before I took warfarin and once after, INR was in normal range.

My first cardiologist said not to worry as long as INR was 2.5 to 4.5, with a target of 2.5 to 3.5.

 

[Ross]

Thing is, we are all so different. Bleeding at 6 or 9 is a very rare thing, but it doesn't mean that it doesn't happen. We need to be proactive in our own care. I know we can't control disease, but we can sure watch our INR for changes and take appropriate actions.

 

[a4wanman]

Agree with Gail on the bacterial/infective endocarditis. I had flu-like systems in September 2009 when H1N1 was hitting schools. After several weeks of "treatment", blood culture reveled enteroccocus durans. Local physicians only prescribed oral antibiotics based on lab results from a local hospital. After consulting my cardio in January 2010, I spent 9 days at Emory Hospital in Atlanta on two different IV antibiotics plus 5 weeks with a pump to clear up the infection.

Scott