Rehab and INR

[a4wanman]

I know several external changes affect INR. Since I'm learning this game, doesn't exercise lower INR? My INR range is 2.5 - 3.5 Weekly warfarin is 27.5 mg.

July 12: INR = 3.1
July 14: started exercises at rehab (rehab 3 days a week and trying to walk at least 30 minutes 2 other days)
July 29: INR = 2.5

Diet has changed minimally since starting rehab. Trying to cut down on sugar and food quantity. Trying to eat better snacks so I won't be as hungry at dinner and supper - fresh and frozen fruit etc. More fiber, wheat bread, etc.

I know 2.5 is in range, but I feel more comfortable around 3. When INR is higher, I might partake in more turnip greens, spinach in salad etc. I know consistency is the key, but I haven't made the effort to eat turnip greens once a week, etc.

 

[Freddie]

I do believe that with some people ones INR will drop as you increase your activity - in this case exercise. You tested today (July 29th) and your going to test again tomorrow, why I'm not sure, so don't be surprised if your results are the same as today.
In my opinion - and someone will correct me if I'm wrong, if you want to increase your dosage take baby steps when adjusting/increasing your weekly dosage. A 5% increase might be enough to get you over that 2.5, but remember it takes 3 to 4 days for an increase to show in a result, that's why you will read often in other threads to test weekly (ideally 5 to 7 days).

 

[Bina]

Some people do have INRs that drop a bit with exercise, but your 2.5 is still okay with a Regent valve, just keep an eye that it doesn't go too low. Eat salad or broccoli a few times a week for good nutrition and stability.

 

[ALCapshaw2]

Who is managing your Coumadin Testing and Dosing?

I would recommend calling your manager if you are not self testing and self dosing.

If you are self dosing, I'm thinking a 1 mg / week increase would be appropriate.
My CRNP manager would typically suggest either a 1 or 2 mg weekly increase at your level.

 

[Philip B]

Exercise & INR

Exercise & INR

Metabolic rate impacts my INR. Regular exercise tends to speed my metabolic rate up so it requires higher coumadin doses to keep in range. I seldom have the same number week-to-week. It typically moves up and down within my range if I dose correctly. I try to adjust in small increases and decreases.

-Philip

 

[Ross]

If it stays around 2.5, which is fine, but you still want it higher to 3, increase your dose by 5% for the week. That should put you at the higher end of your range.

 

[lance]

Hello in upstate N. Carolina
More exercise will increase the blood flow through your liver resulting in lower INR. I noticed this when I entered rehab many moons ago. Also losing weight will lower your INR because warfarin is fat soluble.

If this is incorrect will some please speak up?

 

[dick0236]

As long as I stay in range (my range is also 2.5-3.5) I make no change for a single test that might seem to be a little low. Usually my next INR will be well inside my range. If my next test is still low, I would increase a little....5% would make sense.

 

[a4wanman]

Made a compromise. Tested Friday, INR = 2.4 (did not report to anyone). Tested this morning, INR = 2.3.

Plan: increase from 27.5 mg to 30 mg per week for the 5-10% increase. And test on Friday and report to Philips service. I use 5 mg tablets.

Currently my dosage is Sunday - Saturday: 5 2.5 5 2.5 5 2.5 5

What would be best:

a) 5 2.5 5 5 5 2.5 5 (additional 2.5 mg on Wednesday - 1/2 pill on Monday and Friday)

b) 5 5 2.5 5 2.5 5 5 ( additional 2.5 mg on Wednesday - 1/2 pill on Tuesday and Thursday)


I want to be in the drivers seat instead of the NP.

 

[dick0236]

Made a compromise. Tested Friday, INR = 2.4 (did not report to anyone). Tested this morning, INR = 2.3.

Plan: increase from 27.5 mg to 30 mg per week for the 5-10% increase. And test on Friday and report to Philips service. I use 5 mg tablets.

a) 5 2.5 5 5 5 2.5 5 (additional 2.5 mg on Wednesday - 1/2 pill on Monday and Friday)

.

I'd go with this one.......and use a pill box.