Hi Everyone, I had an endoscopy and a colonoscopy last Friday. I had been off my usual 7.5mg dose of warfarin for 5 days and was taking 80mg shots of Lovenox twice a day for 3 days before the procedures. Everything went fine. INR at procedure was 1.2. I started back on warfarin on Friday evening as well as the Lovenox and have continued both since that time. Protime at Dr yesterday was 1.5. Because I have 2 mechanical valves I need to stay between 3 and 4. The Dr. told me to up my warfarin by a half dose one day a week. I only have 2 shots of Lovenox left. I am worried about being this low for so long. What do you think? Does it usually take this long to get back to levels?
Low ProTime
- Thread starter carlapv
- Start date
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Hi! I also bridged for a procedure. In my case I seemed to go right back up to my normal PT within a few days. I am "weird" however and I do not eat high vitamin K foods, so it took less coumadin to get me back in the zone. I am sure Ross or someone else will weigh in shortly to tell you what works best.
Ross
Well-known member
Carla being a double valver, I'd follow the doctors advice for now. It's not unusual to test low just 3 days after because your first dose is just begginning to show. I would think if they wait 3 more days to test, you'll be in range, but you may have to trim that little half dose boost back.
ALCapshaw2
Well-known member
Yep, INR can "drop like a rock" when you go OFF it, but it can be a Longer Climb to get back into range.
As Ross mentioned, it takes 3 or 4 days for Coumadin / Warfarin to become fully metabolized so it might take a week before your INR is back up to 3.0-4.0
You may want to ask your Doctor to prescribe a few more Lovenox Injections if you are concerned.
Note that you Have Been Protected by the Lovenox so your stroke risk is Low.
Some Doctors do not bridge, just discontinue and then resume Coumadin / Warfarin with several days of Low INR.
As a Double Valver, your risks are higher than a single (aortic) valver so continuing the Lovenox until your INR is back in range would not be a bad idea. Hopefully you will be back in range in another few days.
'AL Capshaw'
As Ross mentioned, it takes 3 or 4 days for Coumadin / Warfarin to become fully metabolized so it might take a week before your INR is back up to 3.0-4.0
You may want to ask your Doctor to prescribe a few more Lovenox Injections if you are concerned.
Note that you Have Been Protected by the Lovenox so your stroke risk is Low.
Some Doctors do not bridge, just discontinue and then resume Coumadin / Warfarin with several days of Low INR.
As a Double Valver, your risks are higher than a single (aortic) valver so continuing the Lovenox until your INR is back in range would not be a bad idea. Hopefully you will be back in range in another few days.
'AL Capshaw'
Thanks Guys, just wasn't sure. The carilologist I used to have would slap me right in to the hospital if it got this low. I am so glad this Doc doesn't panic.
Ross
Well-known member
Lovenox is protecting you. I really don't think you'll need anymore then what you have. 2 or 24 hours worth should be enough to get you over the low INR period. You can always ask for a refill just in case.
