Inr

[Paul1972]

Hi guys could do with a little bit of advise, I’ve been on holiday for a week and my inr has gone up to 4.9 today, should I hold out on same dose to see if comes down on its own or is it best to cut dose right down for a few days,or skip a dose altogether. It’s the first time it’s been over 4. Cheers Paul

 

[carolinemc]

Hi guys could do with a little bit of advise, I’ve been on holiday for a week and my inr has gone up to 4.9 today, should I hold out on same dose to see if comes down on its own or is it best to cut dose right down for a few days,or skip a dose altogether. It’s the first time it’s been over 4. Cheers Paul

Talk to your doctors office where you get the dosing done for advice. Never try to dose yourself.

 

[user 16827]

Hi paul , i once hit 4.4 and self adjusted quite easily with zero drama
i retested at day #4 then again after a week

I would be happy to manage my own dose but not yours

If i was in your shoes i would PM Pell, he's the Man

@toomuchholidaybeer

 

[Paul1972]

Cheers Leadville I was going to adjust a little and test again in a couple of days And yes your right to many beverages each night I think. I’ve only got myself to blame for messing my inr upHope you are well

 

[user 16827]

all good here Paul thanks mate,

Check with Pell but a good starting point at that INR would be to miss a dose

BUT...... I'm not a real doctor

 

[Paul1972]

Thought I’d ask on here first as I feel the group of members on this forum have a lot more knowledge on Anticoagulation than most doctors Especially my doctors who I know ain’t got a clue

 

[user 16827]

absolutely agree

 

[dick0236]

I'd recheck my INR to verify hi INR. If the INR(4.9) is correct......hold a dose and recheck in 3-4 days.....if still hi, call your doc.

 

[user 16827]

Just reminded me, do you still have the lumps and bruises too ?

 

[Paul1972]

Cheers Dick , I will check it again tonight and see what it says

 

[Paul1972]

The bruises have gone but left a fair few hard lumps which hopefully will go

 

[user 16827]

I'd recheck my INR to verify hi INR. If the INR(4.9) is correct......hold a dose and recheck in 3-4 days.....if still hi, call your doc.

50 plus years of experience right there Who's Pellicle ??

 

[Protimenow]

I endorse Dick's suggestion -- recheck.

When my INR was high, and I was 'managed' by a clinic, I was advised to miss a dose, then return to normal dosing the next day and recheck in a few days.

4.9 isn't particularly dangerous - my INR has been higher than that (assuming I trusted the labs - before I knew better). Just don't bump into too many things.

I'm not sure about too much drinking having much to do with an elevated INR.

And MANY of us DO self-manage. It's not very difficult. Trusting doctors or clinics isn't always a good strategy - many of us, whose lives are in our hands, safely and accurately manage our INRs. I can't put much faith in doctors or labs to actually get things right.

(There's still a thread here called 'Outrageous Advice' (or something like that) that demonstrates how well clinics and doctors manage INR.)

The advice to NEVER try to dose ourselves is pure hogwash.

 

[LondonAndy]

all good here Paul thanks mate,

Check with Pell but a good starting point at that INR would be to miss a dose

BUT...... I'm not a real doctor

Not a doctor here either, but this is what I would do too, then retest in 3 days time. Cancel any wood chopping plans during those 3 days ...

And I completely agree with self managing being both achievable and desirable. Yes, you will need to do a little trial and error to start off with, but do so as small "course corrections" occasionally, not drastic or frequent adjustments. In my case, skipping a dose (7mg typically) when my INR was 4.9 would bring my INR down to about 3.8 or a bit more I think, so I would then take 6mg for 3 days (ie 1mg below normal) and test again to see if 3.5 or below.

Same caveats: I am still not a doctor, and your body's reaction may be different. Interest rates may go up as well as down ...

 

[Paul1972]

Cheers for the advice Andy , hope you are doing well I’ve took half my normal dose today I will check it again tomorrow night

 

[Paul1972]

Hi Protimenow , thanks for the advice I appreciate it , I’ve taken half a dose and I will see how it is tomorrow night

 

[Paul1972]

Hi Dick , hope you are well , thanks for you advice it good to get feedback from you it helps a lot with decisions knowing all the knowledge you have accumulated over the years.Regards Paul

 

[pellicle]

Hi
what was your previous dose history (at least for say the last week or (prefereably at least) two, just something like "Xmg per day, INR =Y is enough).

I'm tempted in the absence of knowledge to say "drop 50% of your dose on your next dose time and then resume on the previous".

let me know if you want better than that

 

[pellicle]

I’ve took half my normal dose today I will check it again tomorrow night

looks like you're on to it, but I would wait at least 2 days before re testing because while it may be falling it will take a bit more to settle ... something like this:

all numbers as BARS in the cart are actual measurements (or doses)

 

[Warrick]

Last reading I had over 4.0 was this below . my dose normally around 9mg a day, so I dropped to 6 mg that day continued on a reduced dose. The important thing for me with little hiccups like this is to test and make sure that the INR is responding accordingly and not going too far the other way.
2 days later INR was 2.2 and I continued on 9mg.

I had a 1.7 test 2 weeks ago and took a double dose for that day (due to travel and timezone changes ended up low), I never over shot and next test was 2.7.
For me my INR can change very quickly with dose changes, like in 12 hours, but knowing this makes things a bit easier to factor in.
And I self dose, think it was the start of 2016 since I last had a doctor tell me what to take.

Feb 22, 2019

4.1

6,7,8,9mg