Warfarin management?

[archkre]

Hi,this time I need your help on Warfarin management.
I am taking 21 mg of Coumadin per week, but this time my INP went to 3.4
(in my case it is supposed to be between 2 & 3)
My primary Dr. is on vacation and left a substitute who told me not to take
the Coumadin for 2 days ,which I think is not correct management.
As professor Al taught me the variation should be no more than 10-15% of the week dosage.
Or am I wrong?

 

[geebee]

Daniel,
I would never even alter my dose for a 3.4 (if my range was 2-3). I would continue on the same dose and retest in a week. If it is still higher than I (or my doc) would like, then I would change my weekly dose by only about 5-10%. With a range of 2.0-3.0, I don't even consider a 3.4 to be all that out of range.
Please don't skip any doses.

 

[catwoman]

Daniel:

I agree with Gina. DO NOT SKIP ANY DOSES!!!!!!
Just keep on keepin' on with your same dosage. I never worry about an INR that goes over just a smidgen.
I'll bet that few of us here who work full-time and lead a busy life on our days off stay within our INR range 100% of the time, 365 days of the year.

As we say here, you can replace blood cells but not brain cells.

 

[JimL]

When my INR is 3.4, the nurse tells me it is "perfect"! I completely agree. Don't change your dose at all, and certainly don't hold a dose.

 

[Jan]

I take 5mg one day and 6mg the next this usually keeps my INR at 3.4

once when my INR went to 7.0 ( with no bleeding ) I was told to hold the dose for two days,

I only held the dose for one day and my INR went to 2.0

I would never hold a dose when I was at 3.4

keep smiling

Jan

 

[Blanche]

Inr

Inr

Some people here have INR (International Normalized Ratio) ranges as high as 3.0 to 4.0. Al's had this desired range since 2000 because of a stroke. His INR is usually at or above 3.5. For more information about International Normalized Ratio, please see link below.
http://www.enw.org/Research-INR.htm
Regards,
Blanche

 

[Guest]

It is pretty obvious that the doctor hasn't the slightest idea of how to manage warfarin.

 

[ALCapshaw2]

One more vote for NO CHANGE.

An INR range of 2.0 to 3.0 is recommended ONLY for Aortic Valve Patients with NO other risk factors.

Add ANY additional risks for stroke and you will be told 2.5 to 3.5 Most Mitral Valve Recipients are also told 2.5 to 3.5.

The Generally accepted SAFE Range is 2.0 to 5.0 so 3.4 is 'smack dab' in the middle of the Safe Range, hence my vote for NO CHANGE. Enjoy you weekend and don't worry about it. Check with your Cardiologist next week if you are still concerned.

'AL Capshaw' (AVR Patient with NO Medical Training other than from the Receiving End!)

 

[greg]

My INR is supposed to be 2.5 to 3.0. If I came in at 3.4 I and my cardiologist and just about everyone else would be satisfied. Sometimes close is good enough. That really isn't very far out of line.

 

[Guest]

Setting narrow ranges like + or - 0.5 units instead of the recommended + or - 1.0 units does not improve outcomes. Instead it means that you will be outside your range more often. At least Greg's doctor does not panic when the narrow range cannot be maintained.

 

[twinmaker]

Years ago I had a Hematologist at Johns Hopkins managing my Coumadin because of a life threatening bleed that I had happen. (When the internal bleeding happened, my coumadin was being managed by a cardiologist.) The first thing the Hematologist told me was he wasn't going to change the dosage of my Coumadin unless my INR was WAAAAAY out of range, especially on the high side. His theory was that changing the dosage of Coumadin every time an INR was "out of range" (especially on the high side) was the worst thing one could do. Anyway, I've never had a life threatening bleed since. I manage my own INR now and my INR Thursday night was 3.8 (I have a mechanical mitral vlave) and that was perfect for me! LINDA