Warfarin-How many tablets do you stock up on?

[Natanni]

MORE questions guys

Nathan's doc RX'd him 100 tablets of 5 mg and 40 tablets of 2.5 mg, with refills up to one year. Our insurance company will pay for 3 month supply on his Enalapril so I expected the same for his Warfarin. Well, the pharmacist spaced it out or something because I picked up #30 Enalapril, #30 5 mg Warfarin, and #4 tablets of 2.5 mg. Now that just irked me to no end. He said, "Just break the 5 mgs in half" I guess that is fine, however when doing so earlier, I did note a few wispy powdery crumbs and I informed him of this and reminded him that we always got 3 month supply of BP meds, and then remembered and said that our insurance company is very much in the minority.

Question--What do you guys keep on hand? A one month suppy of your Warfarin? 3 month supply? Do you guys cut pills in half? I told him I will just pay for RX as it is written if there is any issues w/insurance.

Nathan has been taking 5 mg 6 times a week, and 2.5 once a week. He has been in his target range, but he is still on alot of amiodarone, so his dosing isn't caculated in stone yet.

Thanks again

 

[Ross]

When I had insurance I got 60 5mg tablets for the month. I'd actually use 1 and a 1/2 per day.

Now I'm getting the bottles of 100 5mg tabs and still splitting as needed.

It's really silly to get the 2.5's, since it's an unnecessary copay for most people. Just split the 5's.

 

[geebee]

I have my doctor write prescriptions for 100 pills of 5mg with the directions: take 1 or 2 tablets as directed, dispense as written. My insurance pays for 90 days (mail order only) of medications and always fills the script for 100 pills since they can't tell by the script just how many I need in 90 days.

I alternate 5mg & 2.5mg /day and always split the 5mg instead of ordering 2.5mg tablets. I do always take the second half the next time tho so I make sure I am actually getting the correct 5mg dosage.

 

[Nancy]

Joe has just 5mg. tabs. We have a pill cutter--very easy. We use a mail away plan, so get a 3 month supply at a time. The plan knows that Coumadin doses change all the time. They used to give Joe grief when he needed additional, telling him that he had used his allotment for the month or something like that. His doctor worded the script differently--something about titrating according to the test results. Can't remember exactly. That seemed to stop the nonsense.

 

[Rich]

I also have a plan that gets me a three month supply.
I take 2.5mg most days except two days a week I take 5mg.
I just split them in half and have been doing that for over nine years now, and have had no problems.
Like Nancy mentioned there is a pill splitter available at your local drug store,you could get one of those for a couple dollars if that would make it easier.
One side note I should mention is this:
I get my rx's thru Medco, my doctor(and myself also) feel that I should stay with the brand Coumadin, since there were problems with the generic in the past.
If any of you are in that situation Medco has an appeals process which acts on a doctors orders. If approved it will reduce your co-pay by a considerate amount.

 

[Guest]

Getting a Rx for both 5 and 2.5 is unnecessary expense. Probably 80% of my patients split tablets. If a few wispy crumbs is going to make a significant difference I figure that person isn't long for this earth anyhow. Exercise can make a difference - can you always run the same course at the same speed with the wind exactly equal? Food makes a difference. If you dropped a lettuce leaf in a restaurant would you ask the waitperson to rinse it off so that his vegetables would be the same every day? These are reasons why the range is 1.0 units wide - to give some leeway and why narrower ranges make no sense.

In my clinic we have a serious bleed about every 33 patient-years and a clot about every 100 patient-years. If you licked up the wispy crumbs, could control the wind and asked for the lettuce to be rinsed off, maybe you could improve to bleeding every 34 patient-years and clotting every 101 patient-years - but then he would probably forget to take a dose some day and screw the whole thing up again.

You should be conscientious about getting the doses regularly but not let it ruin your week if there is some minor glitch.

 

[Blanche]

I approach hubby's supply of Coumadin in the same way that I approach the general supply necessities for my home.....One product in use and a back-up on the shelf. When the mustard bottle in the frig is empty, open the back-up and put mustard on the grocery list. Al has a supply of 2.0, 3.0 and 5.0 so that he can make-up any combination necessary to maintain an appropriate INR. Our plan provides a 90 day supply for each Rx, with three refills. This has worked out well for quite a while. It does provide a generous back-up, which is espacially nice when we travel.

With regard to splitting, Al has been splitting his Coumadin, as well as Lipitor and other meds for years. I recently saw that the Veterans Admin. here in Phoenix is requiring people to split their medications, and other insurance companies have been doing this for some time. The little bit of powder that results from the splitting has not seemed to matter.

Hope this helps some.

 

[ClickerTicker]

I keep a database of my pill stock and pill use on my Palm handheld. I also have daily repeating diary entries to remind me to take the appropriate warfarin dose and other junk in the morning and again for my evening Ramipril. Beeps loudly if I don't tick off that dose by a certain time. I try to keep 2 months suppy of everything.
Takes a little discipline to update the thing daily, but not much (as I'm not very disciplined).
For any other palm users out there, the database is in HanDBase and the diary stuff is in DateBk5 - both very powerful and easy to use add-ons.
In the UK our pills are pretty much free via our National Health Service, I pay an annual charge of about 130 USD that entitles me to unlimited prescriptions - including my CoaguChek test strips (and before you ask, no, I'm not going to set up a trans-atlantic shipping service ).

 

[catwoman]

Annie:

I have Rxes for 10, 2 and 1 mg and get them from Medco, 90 tabs each. I split the tabs. Medco's been filling my Rxes for about 12-18MO and not balked at sending 3 scrips.

I haven't noticed any perceptible bits or powder when splitting the tabs. Whatever may be there is certainly not as bad as splitting tabs for our cats. (Try splitting one Z-tab into sixths!!!!)

I keep 1 week in my purse + and extra stash in my desk, my overnight bag and my rolling carry-on luggage.

I'm like Blanche about almost anything. So, I usually have 3 months' supply of warfarin at all times. In case of an A-bomb or meteorite hitting the Earth, I'll be OK for at least 3 months, I joke to my husband.

 

[EVELYN]

Tyce has about a 90 day supply on hand....he can refill every 60 days and does so....otherwise the insurance doesn't cover it. We do split when needed, and have used up all his 2.5 mg. that we got from the cardio a bit ago......

Evelyn

 

[Karen7]

For me, pill splitting is a pain. They're always slipping away from the knife onto the floor (where my kids play) or crumbling... I know, I know, I'm the problem . Anyway, I solved it by asking for all 2.5's.

 

[Patrick]

I keep about 4 to 6 months supply and have a stach in work, my car and carry 3 days supply in my pocket. I use a beautiful but ?non-politically correct? 19th century threaded ivory pill-box. I keep a stock of 5, 3 and 1mg tablets and never split them.
Patrick

 

[Lorraine]

I always have a 90 day supply on hand. I too refill after 60 days, so I know I always have back up. I have some I keep in a pill box I keep with me. I especially make sure I have it in the winter. I never know when I may get stranded downtown during a snow storm.

I have a pill cutter that I bought at Osco. Real easy to cut the pills. I get 5mg tablets and split part of them in half for the days I have to take 7.5mg.

I too just spent the last 5 months on Warfarin and my INR stayed at 2.5 which I was not comfortable with. I switched back to Coumadin and now my last two INR"S have been at 3.5. Just where I like it with two mechanical valves!

 

[Guest]

Don't use a knife. Hold the pill with the score line toward you. Put your thumbnails in the score line. With your forefingers pull the outside edges toward you. It cracks approximately in half and you have them in your hands.

 

[Rain]

How long are the pills reliable?

How long are the pills reliable?

I do the three month supply ?order by mail? deal too. And I order the whole dose every time whether I?m out or not. I?m really not paranoid about many things..... but I just hate thinking I may die if some nut decides to blow up the rat killer factory.

What I wonder is.......... how long can you keep the pills without them beginning to lose their potency?? I do use them as I go... I don?t just keep some stored away. But sometimes they do sit there for a few months...... over the last five years, I?ve acquired an impressive supply!! So Marsha... if the factory isn?t pumping the pills back out in three months... come on over, I?ll share with ya.

Yup, listen to Al.... That?s exactly how I do it... now that I'm back on warfarin. Them coumadin pills are a little trickier.... but hey.. You can get a pill splitter for under a dollar.

 

[Granbonny]

The first 3 years I was on Warfarin..I always had the 6 month refill..but, my Cardio's nurse cut it back to 4 months....she said the reason was..so many elderly patients was not taking it. and they wanted to make sure..they were taking it...Now, I have to watch when I pick up my monthy dose....Just looked at bottle..sure enough, no refills...I have to call her..she calls Eckerds..and another 4 months ....refill.......I call her every 4 weeks and tell her my INR....she calls me back the same day.. I home test..but, worry about the many elderly people who miss their daily doseage, ect....who do not home test.. Warfarin is cheap..Less than $20.00 a month....I want mine fresh.. ..Lucky ..it's just next door( Eckerd's) to grocery store...where I go 2 times a week...Bonnie

 

[Granbonny]

Discard date

Discard date

Just looked at my fresh bottle..says..discard date.. same as the day I picked it up..one year later.So, I guess the Barr people thinks it good in the bottle for a year. Hope they are right..Bonnie

 

[BDMc]

Shelf Life

Shelf Life

My impression is that it has an long shelf life if kept in the bottle with the lid on(Read years). I don't have much of a back up though. Brian

 

[ChuckVSP]

Keeping spares of everything.

Keeping spares of everything.

Vowing to myself to never run out of coumadin (or any other med) again, I get my refills for 90 days. I keep 2's and 3's, with my current dose of 3 mg daily. I keep 4 to 7 tablets in my pocket container, and the same in my mailbox at work. I often forget to take my night meds before going to work, and make up for it when I get there. Working night shift (11PM to 7AM) will do that to ya sometimes. It is not a good thing to miss coumadin and whatever else I take.

Chuck

 

[Guest]

Nobody knows how long medications remain potent. It appears to vary from batch to batch even with the same drug. The expiration date on the original package means that it is guaranteed to have at least 90% of its strength if the package is unopened by that date. After it is opened it varies as to storage conditions. Carried with you every day, they will be worn down significantly in a few months. Taking them right after a shower every day in the bathroom will expose them to a lot of humidity which appears to be their worst enemy. The worst I have ever heard of was someone in a humid climate keeping them in the refrigerator. Water must have condensed in the bottle every time it was opened because they just crumbled to bits before the prescription was finished. The longest shelf life should occur when they are kept in the container from the pharmacy and away from direct heat and sunlight.