Self dosing question

[NorthVanJosh]

Hi all,

My INR during my hopsital stay a week ago was all within the 2-3 target range. I have been on 5mg per day. After being discharged my readings went from 2.9 > 2.4 > 1.7 and just today at 1.6. My doctor advised me after the 1.7 reading that if the next reading was below 2 again then he would up my dose by 20%.

Unfortunately he is on vacation until Tuesday and I am unable to get in contact with the heart unit that did my surgery too.

Wondering if I am ok to up my dose to 6mg a day till Tuesday (a 20% increase like he stated). Or am I missing something? Sorry I am new to the whole INR life!

 

[Standardvelocity]

I would increase to 6mg, my dose had to be increased several times after release from hospital. In my opinion higher is more desirable than lower out of range.

 

[pellicle]

Wondering if I am ok to up my dose to 6mg a day till Tuesday (a 20% increase like he stated). Or am I missing something? Sorry I am new to the whole INR life!

yep .. I'd also increase dose. Nobody will smack your wrists.

The actual reason you are on warfarin is to attain a specific INR not a specific dose.

Its pretty well documented that after surgery your recovery will see your "sensitivity to warfarin" decrease (meaning more dose). Surprised me, but I worked it out.

https://pubmed.ncbi.nlm.nih.gov/19336266/

Conclusions: Patients steadily become less sensitive to warfarin during the first months after heart valve surgery. This leads to subtherapeutic anticoagulation. A dosing algorithm that takes increasing requirements into account is proposed. This algorithm will need to be validated prospectively.​

Best Wishes

 

[dick0236]

I agree with Standardlocity to increase to 6mg and followup with your doc.

 

[NorthVanJosh]

Thanks guys. I increased it to 6mg today and will take that till Tuesday when I can talk to the doc. Will also get my blood retested again on Saturday and hopefully see a increase.