INR Up

[MichelleS]

Hi folks,

Over the past six weeks my INR has steadily increased. Today it is 5.1. The only thing I can think of that has changed is that I've added a med called Actonel for bone density and also started taking Citracel+D. (I also take Tegretol.) The doctor has checked and says that these new meds shouldn't have influenced my INR. Nothing else has changed.

Anyhow. they are advising me to hold today's dose (8 mgs) and test again in the morning. When they told me to hold a dose before I plummeted and I know I read here that you shouldn't do that.

Would it be best for me just to cut my dose in half for tonight? I know it's not a dangerously high INR but still high.

Al: Do you know of any interactions with my new meds?

Thanks for any help,
Michelle

 

[Ross]

We need to find out whats making you rise all of sudden. I'm real hesitant about saying what to do until we know this. How fast do you crash holding? Are you bleeding at all? I know I can't hold 2 doses or I'm in the 1.?area. I'm thinking skip one dose and decrease your dosage, spread over the week by 5 or 10% and see where your at then, but like I said, until we know what's causing it don't take anything I say to heart.

 

[Christina]

Hi Michelle,

If you are not bleeding I would just cut the dose in half for a couple days. After that continue regular dose. Test in three days.
I never skip dosages anymore as that makes the numbers go to the bottom. I always cut my dose in half and I've done well with doing this. Mind you, I don't tell my doctor this as he's the one telling me to skip my dose for 48 hours. Not good advise to listen to.
Too scary!

Good Luck!

Christina
__________________________________
AVR's 8/7/00 & 8/18/00
Tucson, AZ

 

[terry40]

Christina

Christina

I just told my dr. "NO" after he said to stop for 2 days 'cause my pt inr was 4.6, I know he was probably shaking his head and wishing I would sign up with some other doctor.

Soooo, I just cut one of my doses in half for 2 days (5mg) and ate some spinach, and a salad, and a bit of broccoli, I take 7.5mg 3x a week & 10mg 4x a week. I'm just hoping it didn't go low, I had the darness time getting it in range. I was tested at the lab today.

Just to let you know I'm not disrespectful, I use to work with this doctor, before I took off to teach for 2 years, and then I worked with the kiddies for the next year.

Terry40

 

[MichelleS]

Hi again,

Thanks to everyone who's replied so far.

I'm not bleeding (at least anywhere I can see!) : ) so I went ahead and took 4mgs (instead of my normal 8) this afternoon. They told me to test again in the morning, which seems silly - no time for it to settle down!

I didn't want to skip a whole dose because I kept thinking back to last time they told me to hold one day - I went from 4.6 to 1.8! I remember Al explaining that since I take a relatively large dose (8-10mgs) that my "crash" would be that much worse.

I'm just more interested in knowing why it's been going up. I've been under more stress than normal (my dad just had heart surgery himself) and missed ONE day of my normal exercise routine, but otherwise I can't say that much has changed except for the addition of Actonel and Citracal+D (*not* Citracel as I said in my other post) about six weeks ago.

I've been pretty lucky for the four years I've been on coumadin - this is the highest my INR has ever been!

Thanks again for the replies so far and hope everyone's well.

Cheers,
Michelle

 

[ALCapshaw2]

Someone (Rain?) posted a chart that showed 'events' vs. INR

I concluded that readings from 2 to 5 were pretty safe and did NOT call for *drastic* measures such as holding a dose. Personally, I favor the half dose approach to skipping a dose, and then adjusting by the 10% protocol.

'AL'

 

[Guest]

I hardly ever have anyone hold a dose for an INR less than 5. Above 5, I might. Or I might just have them take half a dose for a day or two. I kind of base it of the person, too. I tell them that either way will probably work and I ask which one they feel more comfortable with.

I try to avoid people coming back and saying, "I told you so." That way they think that I am smart.