Wanted opinions

[cocoalab]

Andrew's INR was 3.5 and a about a week later retested at 5.6. He tested again later that day and it was the same- we were checking for acuracy since he did it on his own but in the car (long story) . He was told to skip one dose and retest the next day to make sure it was not going up. The next day it was already down to 3.7 and we resumed his normal dosing. We will test again on Monday. Anyways he was sick with a virus but had no other changes that I know of. Do you think the illness caused this jump in his INR or what? That is what the nurse is speculating and no he did not take any meds. He had been on amoxicillin for an ear infection a couple weeks before. Just wanted to hear some opinions. He has been kind of stable for about a month I think. He only takes 2.5 mg a day with one day of 5 which we may change depending on how his INR is Monday.

 

[Ross]

For 5.6, I'd of skipped one and a half doses and retested in 4 days. What she's having you do sounds reasonable. It depends on what kind of virus he had, some make it go up, some down.

 

[Karlynn]

Many antibiotics will raise the INR. If the virus he also had kept him from eating as much, then it's also a culprit for a higher INR.

The good news is - you know that it was illness and circumstances that caused the higher INR, so it shouldn't be too hard to get him back on track.

If his INR the next day was 3.7, it wasn't registering the full skipped dose yet, so his INR was probably on it's way back down from the 5.6 before the skipped dose. It may have been one of those things where you never would have known he was out of range if you didn't test that day.

Sounds like you got good advice. Glad they just had him resume his normal dose.

 

[cocoalab]

Thank you for your input. He was in for a cardiologist visit and was tested again and is now at 2.8. we are going to try 3 mg each day and retest next Wednesday. Guess we will see if that works better than the other dose. He had been too low earlier in the month as well (1.6) So it has been a litle bit of a roller coaster I guess. His visit was encouraging though and he has continued to improve since his long illness with the BE and surgeries. Yay!!!

Wendy

 

[ALCapshaw2]

Hmm...

Your comment about being on Amoxicillin (an antibiotic) caught my attention. Antibiotics are notorious for raising INR.

How Long was he on the Amoxicillin?

Did he check his INR while he was on it, or sometime in the next few days after he completed his course?

'AL Capshaw'

 

[cocoalab]

Al sorry this is so late but I only get on line infrequently.
Andrew was on the amox on the 11th of OCT. He was tested on the 31st when it was high at 5.6. By the first it was down to 3.7 and he had gone to the doctor because he was sick. It seemed to be a virus so no antibiotics then either. By the 9th of Nov he was down to 2.8. I am noticing we have not been eating a lot of green veggies lately because of our scheduels. I think we are going to have to be more consistant with that- my bad! I half expect his INR to be too high Wed when we test again. Thanks for your imput I think it was to soon before to effect it that much. Do you agree?

 

[ALCapshaw2]

Al sorry this is so late but I only get on line infrequently.
Andrew was on the amox on the 11th of OCT. He was tested on the 31st when it was high at 5.6. By the first it was down to 3.7 and he had gone to the doctor because he was sick. It seemed to be a virus so no antibiotics then either. By the 9th of Nov he was down to 2.8. I am noticing we have not been eating a lot of green veggies lately because of our scheduels. I think we are going to have to be more consistant with that- my bad! I half expect his INR to be too high Wed when we test again. Thanks for your imput I think it was to soon before to effect it that much. Do you agree?

I'm still confused. Was he only on the Amoxicillin for ONE DAY (i.e. Oct 11)? Or did he start on Oct 11 for ??? days?

It sounds like there are / were several mitigating factors all of which could have an effect.

The important thing is that he is back in range and consistent in his diet and medications. Frequent Monitoring until his INR is proven stable is the prudent course.

Best Wishes,

'AL Capshaw'

 

[cocoalab]

I'm sorry (again) he started on the 11th and was on for 10 days or so.

He retested Wednesday and was at 4.3 or somewhere around that after 13 days of the 3 mg dose. We have not been eating our veggies too much so think it might be a little high because of that. I forgot to call today, as it feels like a holiday, to see if they want to change the dose.