My INR keeps going up up up!

Heidi511 · Jul 8, 2005

Hi-
I had my surgery one year ago March. My INR levels were fine and I got down to once-a-month testing. Then last October, I had a high reading, and I've been testing every week to 10 days ever since. Today I got a call from my lab that basically accused me of taking a double dose. My level is over 5. Usually I start to have abdominal bruising when my levels are higher, and I can tell. None this time. I'm taking 10 mg of warfarin daily, except for Monday and Friday when I take 9 mg. Now they want me to skip today's and tomorrow's dose and continue on with 9 mg daily. This is driving me nuts. I don't know what's causing it to rise. I am not a big drinker. I usually have a glass of wine or a beer each day for consistency. Could an extra glass of wine make it rise by that much? I had two glasses on Sunday and had my blood checked on Thursday. I am very consistent with my salad per day as well. Do some bodies have high INR levels naturally? Do people metabolize warfarin differently? Should I see a nutritionist to help evaluate my diet? Aaah!
Anything will be helpful at this point. Thanks.

Guest · Jul 8, 2005

It is your warfarin manager that is messing you up. Holding warfarin for two days for someone who takes as much warfarin as you do will drop your level to the danger zone. The reason that you take a high dose of warfarin is because you metabolize it rapidly. The warfarin manager does not understand how warfarin works nor the minimal risk of an INR of 5. There is a much greater risk of having an INR that is more than 0.2 untis under the range than slightly high.

Ross · Jul 8, 2005

Are you eating or are you like me and just live on Coumadin?

jeffp · Jul 8, 2005

I'd be glad to trade you. I keep getting my dosage upped and my INR keeps dropping. I'm attributing it to the exercise intensity at cardiac rehab (probably wrongly so). Still waiting to get home testing started, hate the frequent blood draws - my veins are getting wiped out! 5.0 is better than 1.6

Karlynn · Jul 8, 2005

Heidi
What Al said.

If you go to http://www.aafp.org/afp/990201ap/635.html and scroll about 1/2 way down, you will begin to see the guideline charts for what is recommended for INR management when a too low, or too high reading occurs.

I went

when I read that they told you to hold 2 doses. If I did that (and I take a pretty high dose too) it would tank my INR. How high above 5 is your INR? Are you keeping a chart of your dose and your INR at for each test? I have a graph that I plot my INR on, with the dose recorded at the bottom. This allows me to see the progression.

Sounds like it's time for you to find another Coumadin manager, or become your own manager. With Al's knowledge, and the good people here, I've become my own manager - with the blessing of my cardiologist.

Granbonny would tell you to have a V8 today if the >5 scares you. Sounds like you're being very consistant. I'd just gradually, in small increments, adjust the dose to your range.
Best Wishes!

Guest · Jul 8, 2005

Jeff, The dropping INR is probably rightly attributed to the exercise.

You can print a monitoring chart from my website http://www.warfarinfo.com/monitoringgraph.htm