Low INR of 1.8

[alicia]

I too have so many problems getting my INR levels adjusted. I was on a roll and continued to test and have a result of 3 (which is great for a St Judes mitral valve). Of course this was all screwed up a few weeks ago when I ended up with a terrible upper respiratory infection and had to take antibiotics and other meds that messed it up. Results were as follows..
on 11/21 it was 3.9
on 11/28 it was 2.2
on 12/5 it was 1.8
My cardiologist (who manages my Coumadin) had me take 10mg last night, 10 mg tonight and 7.5 after that until I get tested again Friday or Monday. My question is, wont this high doses boost me up too high? When my INR gets over 4 I end up with terrible nosebleeds and spit up lots of blood. Im so afraid this is going to happen. Any advise? My normal doseage that was working so well was 7.5mg everyday except for 5mg once a week. Please help. I've been having these problems for almost 3 years now since my last open heart surgery.

Thanks, Alicia

 

[geebee]

A couple of questions come to mind.
1. Were you consistently around 3.0 on the 7.5mg daily regime and only the infection meds messed it up?
2. Have you stopped those meds?

If you have stopped the meds, your INR should come back up to 3.0 on its own although taking 10mg today wouldn't hurt anything.

If you are still taking the meds, based on a 1.8 INR, the new regime your doctor gave you should keep you in the right range until you stop the meds.

 

[Karlynn]

Did the dr. decrease your dose after testing the 3.9? If so, how much? I would not have made any changes for a 3.9, but with your issues a small adjustment for a day or two would have been appropriate.

You take a large enough dose regularly that I don't think 10 for 2 nights is going to push you too high.

Did you suffer from nose bleeds prior to Coumadin? It sounds like you may have some vessel/s that could be cauterized. Do you always bleed when going above 4?

Personally, I'd be more comfortable risking a nose bleed than to continue 1.8 It's much easier to lower an INR than to raise it. So given that you were on antibiotics I think I would have been more inclined to throw in a few spinach salads and some V-8 rather than change my dose to decrease the high from antibiotics, because you know that the effect will leave and your INR will drop.

All this being said - I home test because I've never been stable - 14 years of ups and downs. I've learned to go with the flow for the most part and have learned what I need to do to my dose to get some movement in the INR. I still hate the lows, though.

 

[alicia]

Belated Happy Birthday K...I have had so many problems since being put on Coumadin. I have never had a nosebleed until after Coumadin. I usually do bleed with a higher INR of 4 or higher. I double dosed one day and ate the wrong thing and ended up in ER with severe nosebleed and spitting up blood and an INR of 7.5 and stayed in there for 3 days and went home taking Lovenox for 2 weeks. Yuck!! I agree what you are saying. I feel fine today (thur) and will get rechecked next week.

If your level gets as low as 1.8 as mine did, what is the chances of it causing a stroke? Just curious.

 

[Guest]

An INR of 1.8 for a few days has a pretty low likelihood of causing a stroke. Hardly any for an aortic valve, a little more for a mitral.