Need dosage help

[Robbyn]

My INR is 4.7 and should be 3.0-3.5. Could someone please advise me what take today and tomorrow. I take 7 mgs daily.

Also another question. I have been taking Tylenol 3's, as I broke my arm. I thought acetaminophen was okay with warfarin. I have taken Tylenol 2's with no affect on my INR. Although because of the pain I have taken them for almost a week.

Thank you for any help you may have.

 

[dick0236]

The guide I use says to hold one dose OR reduce weekly dose by 10-15% for INR under 5 and recheck in one week. I can't help with the Tylenol question as I don't know what Tylelnol 2 or 3 are. I have been taking two 500mg tabs of Regular Tylenol nightly for several years with no problem with INR.

 

[Freddie]

Like Dick has mentioned and according to the online dosage web site (http://www.pace-med-apps.com/CoumCalc.htm): decrease dosage 10% check INR in 4 to 8 days.
New dosage is according the web site:
Day 1: 6mg, Day 2: 6mg Day 3: 6mg, Day 4: 7mg, Day 5: 6mg, Day 6: 7mg, Day 7: 6mg

Don't panic, eat a few more greens and your results should be back in range.

Just curious, you mentioned your range is 3.0 to 3.5, that is an very narrow range. I too have had my mitral valve replaced with the range of 2.5 to 3.5 with my GP and cardio are both fine if I go above 3.5. There is no panic if I tell them my INR is 4.1. Did your surgeon, cardio or GP mentioned this range that you currently on?

 

[pellicle]

Hi

...Could someone please advise me what take today and tomorrow. I take 7 mgs daily.

Also another question. I have been taking Tylenol 3's, as I broke my arm. I thought acetaminophen was okay with warfarin. I have taken Tylenol 2's with no affect on my INR.

there is a known reaction which will cause it to raise:
http://www.ncbi.nlm.nih.gov/pubmed/17145598

RESULTS:
Mean INR rose rapidly after the start of paracetamol and was significantly increased within one week of paracetamol intake

I agree with the others here, make a minimal adjustment, but perhaps just leave it as is (if its been stable that's good) and eat some broccoli and a heap of spinach. If its a temporary high then the intake of Vit K will bring it down naturally and it will probably resume as it was.

If you make any change, then make any change small.

Best Wishes

 

[Patsman07]

Im new to all this seen as I only had my aortic valve replacement 12 days ago. I had been getting 3mg a day in hospital. When I left hospital two days ago my inr was 3.4 so doctor told me not to take any warfarin that day and only 1mg the next. I thought this was excessively low amount? Getting blood tested in a few hours but Im a bit worried I might be too low.

 

[pellicle]

Hi Patsman

glad to hear you're ok

When I left hospital two days ago my inr was 3.4

seems good ...

so doctor told me not to take any warfarin that day and only 1mg the next.

:thumbd:

I thought this was excessively low amount?

with you on that one!

Getting blood tested in a few hours but Im a bit worried I might be too low.

well, even if it goes down to (say) 1.8 its not going to cause any harm for a short duration (like a few days sorta thing).

Hopefully your INR managers will get you on the slightly wiggly and hopefully narrow path ;-)

Anyway, have someone bring you a half pint of Guinnes and have a relax during your recovery.

Best Wishes

 

[Patsman07]

Thanks Pellicle