Lovenox Injections

Gary Miller · Sep 13, 2013

This is another new experience for me in my Valve Replacement life. I went to the ER yesterday as I have been having some troubling symptoms that I think might be either an infection or maybe the mitral valve is going bad now (as it was showing mild leakage before the AV replacement, but cardio said it was common for a guy my age not to worry.) At the ER my BP was 197/100 and they did the routine blood tests and chest x-rays. After about an hour the BP started dropping back to my normal 130/77 and they were getting the release ready. The Doctor came in and said your INR is low (1.8) and had the nurse come in and inject me with 100mg of lovenox and prescribed 10 more for home use to bridge me until my INR was at 2.0. Those shots kind of smarts! I have been taking Saw Palmetto supplements for my prostrate for about a week. He didn't see any contradictions in his PDR but thought it was probably the cause if nothing else has change in diet or activity. I thought I would check my meter with the lab results when I got home. It was about 2 hours after the shot when I checked and my meter showed 2.0. The question is, can the lovenox work that fast or is my meter off by .2 now? My meter a Coagucheck XS has been right on every time I have compared to the 3 local labs. Its a good reinforcement that weekly testing pays off.

clay_from_nj · Sep 13, 2013

This thread has a similar discussion...http://www.valvereplacement.org/forums/showthread.php?39888-Affect-of-Lovenox-shots-on-INR

Stopper · Sep 13, 2013

Gary,

I don't think Lovenox will show up on any INR machine. I wonder if there is just a difference between your monitor and the monitor at the hospital. I hope you feel better.

Protimenow · Sep 13, 2013

It seems to me that your ER doctor may have been a bit quick with the Lovenox (although it probably would have protected the ER from any liability claims) - IF your test last week was 2.0 or higher. The clinics at the Duke Medical Center have a protocol that temporarily increases the dosage if you drop below 2.0 -- the real risks are if you're below 2.0 for more than a week (I should know, I trusted a different meter, believed that a 2.6 was safe, and had a mild TIA). I don't think the CoaguChek XS will show results of the Low Density Heparin (Lovenox), so your ability to clot may be considerably lower than your meter shows. If you're saying that you have to take Lovenox TEN TIMES, this seems to be a bit much -- of course, I'm not a doctor, so it is probably best to talk to your cardiologist to get confirmation that this course of actiorn, rather than just increasing your dose of warfarin for a few days, is the best way to go.

Bina · Sep 14, 2013

Gary Miller said:
This is another new experience for me in my Valve Replacement life. I went to the ER yesterday as I have been having some troubling symptoms that I think might be either an infection or maybe the mitral valve is going bad now (as it was showing mild leakage before the AV replacement, but cardio said it was common for a guy my age not to worry.) At the ER my BP was 197/100 and they did the routine blood tests and chest x-rays. After about an hour the BP started dropping back to my normal 130/77 and they were getting the release ready. The Doctor came in and said your INR is low (1.8) and had the nurse come in and inject me with 100mg of lovenox and prescribed 10 more for home use to bridge me until my INR was at 2.0. Those shots kind of smarts! I have been taking Saw Palmetto supplements for my prostrate for about a week. He didn't see any contradictions in his PDR but thought it was probably the cause if nothing else has change in diet or activity. I thought I would check my meter with the lab results when I got home. It was about 2 hours after the shot when I checked and my meter showed 2.0. The question is, can the lovenox work that fast or is my meter off by .2 now? My meter a Coagucheck XS has been right on every time I have compared to the 3 local labs. Its a good reinforcement that weekly testing pays off.

Hi Gary,
Sorry to hear about your troubling symptoms and high BP....these things do happen in the first year or so after VR, and in my case even the second year.

Regarding your low INR, my doc would have definitely sent me home with a few Lovenox shots because they act quickly and safely until your daily Coumadin can raise your INR.
(Lovenox will protect you, but not show up as a "raised INR" on your home tester.)

The .2 difference in your results between home and hospital is entirely normal and that is why we have an INR "range" to guide us.
My preferred reading is around 3.0 so that I can enjoy my salads and veggies daily without putting a dent in my INR.
Best wishes, take a big breath and relax