Mechanical valvers, what's your INR vs. Warfarin dose?

[bgilbert]

I am just curious how much Warfarin most people end up taking.. I'm 4 months post-op and 50 years old. I have a Regent valve, and am shooting for 2.0-3.0 INR. My INR is 1.8 currently and I'm taking 10mg two days a week and 7.5mg the other days.. My nurse seems very hesitant to raise my Warfarin dose for whatever reason - In 4 months I was only in range once, and even that seemed to be a fluke due to other meds I was taking at the time.. I know of course there are a lot of variables from person to person, but I am just curious as to what dose is required for most people. I was told that it is about 5 to 7.5 mg daily, but for me that just isn't going to be sufficient. I have a friend who is ten years younger and takes 15mg three times a week and 10mg the other days. I think for me I will need to take 10mg a day or so. Curious to see "actual mileage" of others who have been playing this game longer than I.

Brian

 

[pellicle]

Your nurse is an idiot


http://www.medscape.com/viewarticle/581599

Warfarin is a medication that, with few exceptions, is dosed to effect

Also see
http://www.valvereplacement.org/foru...e-on-17mg-aday

http://www.valvereplacement.org/for...tion/26524-the-largest-daily-dose-of-warfarin

Sadly I just had to help someone dealing with exactly this sort of idiot today.

They lost

 

[dick0236]

The simple answer is.....it takes what it takes. When I was young(30s-50s) it took about 70mg/wk because I was very active. Now, at 80, I take about half of that (38mg/wk) due to my physical activity has decreased. You are soon after surgery and your activity is probably increasing requiring more ac. I'd bump it up by about 10% and test in a week. I would also go on home monitoring.

 

[pellicle]

Brian

I agree with Dicks post, the sooner you can self test and preferably self dose the better.

When you do this blog post of mine may help you along
http://cjeastwd.blogspot.com/2014/09/managing-my-inr.html

 

[bgilbert]

Thanks for the replies and links! I recently received my machine and went on self-testing which definitely helps a good bit. Today after the 1.8 reading a different nurse called and advised that I increase my dose by 2.5mg one more day a week, so hopefully that will raise it more on my next test and get me in range. We'll see...

 

[DachsieMom]

I have a st Jude regent with Dacron. April will be 2 years. I am surprised at my high dose given that I am petite - 4'10' and 100 lbs. I am usually on 7.5 per day but now take 10 mg twice per week, 7.5 all other days. My cardio wants me at 2.3-2.8. My surgeon wanted 1.8-2.2 but my cardio overruled him. I also take aspirin. I'm 43.

 

[Ryanvs]

Hello. 31, target INR range of 2-3. Current dose of 6.5mg per day. At this dose my INR has fluctuated between 2.2-2.8.

 

[jwinter]

INR range for me is 2.5 to 3.5 and I am now taking 4 mg 5 days a week and 3 mg. 2 days a week. INR 2.8 last week.

 

[vivekd]

INR Range 2.0 - 3.0
Warfarin 16 mg every day

 

[ForeverThankful]

My INR range is 2.2 to 3.2
My Warfarin dose right now is 4mg per day
My INR was 2.8 today

 

[Owenall]

My INR range is 2.5 to 3.5
My Warfarin dose is 12mg for 3 days and 10.5mg for 4 days
My INR was
3.4 yesterday

 

[sood]

My INR range is 1.5 - 2.0 (I have an on-x value which I got installed in 2013!). I also take an 81 mg aspirin. This has been my range for almost the past year plus.
I take approximately 52.5 mg of warfarin per week.

 

[Warrick]

9 mg a day for last 4 weeks, sometimes 9.5mgs daily for a few weeks at a time , last INR on friday was 2.7, range 2-3, 100 mg aspirin

 

[LondonAndy]

Range = 2.5 to 3.5, and am currently alternating between 8mg one day, 9mg the next. Last week's INR was 3.4, and will be testing again tomorrow.

So if you are taking 10mg for 3 days per week and 7.5mg for 4 days per week, that's an average of 8.57mg per day (60mg/7). I am not a doctor, but personally I would be aiming for a more consistent dose (to even out the reducing effect of the warfarin), so as my weekly total is the same perhaps consider alternating 8mg and 9mg too? To be honest, I don't tell my clinic what dose I actually take - though it is nice to know that they are there for advice if ever something drastic happened, or I otherwise needed advice, and I still see them every six months to check the meter is maintaining it's accuracy). As far as I am concerned, if I am staying in range through minor "course corrections" I do myself, as is already accepted practice for insulin dependent diabetics adjusting our dose ourselves, the nurse will be happy and I feel safer. I have been 98% in range for over a year now.

 

[Heart Of The Sunrise]

Inr 1.8-2.2 5 mg coumadin per day self-test - Coaguchek XS- 81 MG ASPRIN PER DAY

 

[Superman]

2.5 - 3.5 range
3.1 at last test
6 mg daily
44 years, 26 plus years on warfarin.

Self test, and take aspirin and metoprolol as well.

 

[pellicle]

I see this three week old thread is serving as its title suggested initially, so for me it's
INR target = 2.5
Dose varies between 6.5 & 7.5 mg per day varying slightly over the year with minor adjustments as required.

you can see its stable for most of the time (dose I mean) then sometimes things seem to shift and I need to manage that and re-evaluate my new dose level (which you can see usually isn't different by much)

Self management including self testing for about 5 years.

 

[brindle1]

inr range is 2.5 to 3.5
warfarin dose is 5mg 6 days 4mg 1 day

 

[MrsBray]

45/f
overweight, becoming more active
eat greens 4-5x/week
range 1.5-2.5
consistently test @ clinic every 5 weeks, 1.9-2.8
alternate 7.5 & 10 mg

 

[marc_kowal]

45 year old somewhat active male.
2.5 - 3.5 is my target INR
4.5 mgs every day except 6 mgs Tues and Thurs
Eat about 90 mgs of Vitamin K foods daily.
Self test once a week