Trouble regulating coumadin

Valve Replacement Forums

Help Support Valve Replacement Forums:

This site may earn a commission from merchant affiliate links, including eBay, Amazon, and others.

Praline

VR.org Supporter
Supporting Member
Joined
Dec 18, 2005
Messages
1,079
Location
Louisiana
I started taking warfarin about 2 months ago, at the beginning of November. After a couple of weeks,I was between 2.6 and 3.0. I was taking 7.5 mg 4 days and 5.0 mg 3 days, alternating of course.
Then November 22nd I had a TEE. They lowered the dosage at that time right before then I went back to 7.5mg 5 days and 5.0mg 2 days. Next week I was at 2.0. They told me to take 7.5 mg every day except 5.0 mg on one day.Then the next week I was down to 1.6. They had me take 7.5 all week. But I stopped on the 24th and had an angiogram December 27.That night they had me take 5 mg. Then I have been taking 7.5 since.Today I am at 1.7. They told me to take 10mg today and 7.5 for the rest of the week and then retest next Monday.
I am a small person, about 5 feet 2 inches. I weighed 117 pounds when I went for my physical November 4th. Now I am about 110. I have always had a hard time maintaining my weight. I eat enough but with cutting down on fat and caffeine, what can you eat that has calories and is low fat? I do not care for pasta or rice.No fried food, no desserts, no cokes, no coffee so no half and half, no butter...Also the first couple of weeks after I found out I was not as healthy as I thought I was, I could hardly eat..a combination of anxiety and new meds I think. But now I am back to eating normal. I eat a lot of fish, chicken, I eat broccoli or brussel sprouts a couple of times a week, once at the beginning of the week and once toward the end. I eat a variety of fruit and my favorite veggies are carrots and butternut squash. I also eat a lot of potatoes. I love bread.
This is all new to me. The nurse at the coumadin clinic asked me a couple of weeks ago if I was sure if it was possible I had not missed a dose but I told her no because I have a pill box and fill it by the week. She said, " Good idea".
When I first started taking coumadin. I was taking it at lunch. Then I started taking it at dinner time. That would not make a difference, would it?
I also drink a glass of red wine with dinner. I am going to talk to my cardiologist to see if I should stop but for now it helps me relax and I sure need it right now. I have been doing this for a long time. You have to remember that I live in the New Orleans area so according to a lot of people around here , that makes me practically a non drinker.:rolleyes:
Any advice or comments? The coumadin nurse thinks it is because I keep starting again.
 
What are your other medications?

Could you maybe be feasting on hidden Vit K and not know, ie, sure boost, carnation instant breakfasts, breakfast bars?

Are you excercising a lot more recently?

The time you take the pill is when you take it, time doesn't much matter because the drug is so slow metabolizing in the system. Your height and weight have little to nothing to do with the amount of Coumadin you'll need to stay in range. That's up to your liver to decide. Drinking a glass or two of wine a day isn't going to be a factor either.

Somethings' changed, but only you can put the finger on that change.
 
It is fairly common for the warfarin dose to need increasing after you start to recover. Check out the things that Ross listed. If you can't find any other reason, it is probably because you are feeling better. There are at least 4 variations on the liver enzyme that metabolizes warfarin. You probably have the one that metabolizes the fastest. People who take doses greater than about 6 mg daily are usually fast metabolizers. When they hold a dose, the bottom falls out of the INR very quickly. They also tend to be very hard to get the INR back up into range because they metabolize the drug so fast.
 
Back
Top