What would cause INR to rise

[Jackie]

other than diet, meds, exercise? My INR was 3.2 on Friday April 10, and today it is 4.3. in five days it went up 1.1. Nothing has changed except maybe a little stress. Will stress raise INR? My son is getting married this Saturday, and I am planning a 90th birthday party for my mother next Saturday.

I was just told by the Anticoaguation Clinic to hold 4mg tonight. I told her that I couldn't do that, so she said to take 2mg tonight and 2mg tomorrow. I have been taking 4mg a day. Does that sound right? I do know when I hold a dose my INR drops really fast. My range is 2.5 to 3.5.

 

[Freddie]

oh yes indeed, stress will effect your INR. Ross told me so. Mine usually goes down....way down. Sorry I can't help you with changing your dosage.

 

[catwoman]

Jackie:

Stress can affect your eating habits. Some people skip meals or eat less or different foods when stressed; some overeat.
When I get busy and stressed, I don't drink as much fluid, causing dehydration, sending my INR up.

You've got a lot going on right now. I wouldn't halve my dose for more than 1 day. Just retest several days after all your special events are over and you're back on an even keel and see if you're back to normal.

 

[ALCapshaw2]

It could be a number of things, including a slightly erroneous test.

What kind of test / tester did you have?
(Lab draw, Home Test, Clinic Test by Finger Stick?)

I've seen slightly elevated Finger Stick testers at my clinic (as compared with Lab Draws for verification)

IF your INR is truly 4.2, I second 'Catwoman's' suggestion of holding 1/2 dose for 1 day. That's what I would do if that was my reading (maybe even only hold 1/4 dose if your range is 2.5 to 3.5).

 

[Ross]

Rains dog in the flower bed again?

 

[Jackie]

I have included a list of my past INR tests. I test on my INRatio and go for a comparison test every 10th week at the lab unless my reading is over 4. I tested three times to be sure yesterday, 4.8, 4.3 & 4,0, The lab was 4.0. I had taken 5mg 5 days a week and 4mg 2 days a week for 2 1/2 years. mow I am down to 4mg a day. My INR just goes up and down now matter what I do. The lab and I are usually very close, .2 to .5 difference.
I really have not made any changes in my diet, even on Easter except maybe a chocolate egg, and my exercise level .
Standard Range 0.9-1.1 Ratio
7/3/08 3.6 WARFARIN
7/11/08 2.9 WARFARIN
8/14/08 4.2 WARFARIN
9/3/08 2.9 WARFARIN
10/16/08 3.6 WARFARIN
12/10/08 3.8 WARFARIN
1/14/09 5.0 WARFARIN
3/18/09 3.9 WARFARIN
4/10/09 3.2 BASELINE
4/15/09 4.3 WARFARIN

Are there any medical reasons why it would do this? Thank you for your input it is appreciated. I started checking my INR closely when I got bruises on my feet and hands. I did have a full blood count done.was normal..........He did blame the Warfarin........
I do have Arthritis in my hands, feet and back. Yes I am OLD, would the Arthritis make this differance? Just trying to find an answer, I thought I had the Warfarin figured out!!

 

[Jackie]

oops, the lab yesterday wayh 4.3

 

[catwoman]

Jackie:

You say you are OLD... Exactly how old are you? You may have become more sensitive to warfarin due to age. Some people over 65 do.

You may have mismeasured your tablets and taken too much one day.

Just retest in about 4-7 days and see what you get.

Why do you do a lab draw every 10 weeks?

 

[Jackie]

Jackie:

You say you are OLD... Exactly how old are you? You may have become more sensitive to warfarin due to age. Some people over 65 do.

You may have mismeasured your tablets and taken too much one day.

Just retest in about 4-7 days and see what you get.

Why do you do a lab draw every 10 weeks?

Catwoman, I will b e 69 in August. Medicare says I should test once a week, and Kaiser says I must go in for a blood draw every 10 week unless INR is 4.0 and above or 1.7 or below, then I must go in at that time. I have a 7 day pill box that I fill every Saturday, and I do check very closely to make sure I take 2 4mg tables every night at 7:00, so I really don't think it could be an over dose.

 

[catwoman]

Catwoman, I will b e 69 in August. Medicare says I should test once a week, and Kaiser says I must go in for a blood draw every 10 week unless INR is 4.0 and above or 1.7 or below, then I must go in at that time. I have a 7 day pill box that I fill every Saturday, and I do check very closely to make sure I take 2 4mg tables every night at 7:00, so I really don't think it could be an over dose.

Jackie:
That's not OLD!

 

[Jackie]

Catwoman, I will b e 69 in August. Medicare says I should test once a week, and Kaiser says I must go in for a blood draw every 10 week unless INR is 4.0 and above or 1.7 or below, then I must go in at that time. I have a 7 day pill box that I fill every Saturday, and I do check very closely to make sure I take 2 4mg tables every night at 7:00, so I really don't think it could be an over dose.

I don't take 2-4mg tablets I take 2 - 2mg tablets. My Doc did call me old on Monday, thats why I have bruises on my feet and hands all at the same time. I told him that I walk on my toes and run in to walls. Then I told him to forget it, it's all in my head. When I told my son, he said "Mom I know it is frustrating to never get an answser, but, I'm glad I wasn't there"

 

[Bina]

Jackie....(hint) take advice from those of us who are compliant patients, take our meds, and test regularly.
We know what we are doing.
Your INR of 4.3 was not a big deal, and I also would have taken a half dose for one day.
Sometimes mine creeps up a bit. You are doing very well.

 

[Blanche]

Jackie

Jackie

I totally agree with Bina. I have had three years of INR testing and Albert has had 9 years of INR testing. We test weekly. We are compliant patients, take our meds as prescribed, and test regularly.

Albert's range is 3.0 to 4.0. His INR has been at 4.3 and above more than several times. He usually just lowered his dose slightly. Mine went to 6.0 once recently. I attribute it to stress, and my doc agrees. I cut my dose in 1/2 for one day and that worked for me. My range is 2.0 to 3.0.

There is so much mis-information going around. Someone told Albert, years ago, that people with heart valves had to be very careful because sex makes the INR decline.

Kind regrds,
Blanche

 

[Ross]

I have included a list of my past INR tests. I test on my INRatio and go for a comparison test every 10th week at the lab unless my reading is over 4. I tested three times to be sure yesterday, 4.8, 4.3 & 4,0, The lab was 4.0. I had taken 5mg 5 days a week and 4mg 2 days a week for 2 1/2 years. mow I am down to 4mg a day. My INR just goes up and down now matter what I do. The lab and I are usually very close, .2 to .5 difference.
I really have not made any changes in my diet, even on Easter except maybe a chocolate egg, and my exercise level .
Standard Range 0.9-1.1 Ratio
7/3/08 3.6 WARFARIN
7/11/08 2.9 WARFARIN
8/14/08 4.2 WARFARIN
9/3/08 2.9 WARFARIN
10/16/08 3.6 WARFARIN
12/10/08 3.8 WARFARIN
1/14/09 5.0 WARFARIN
3/18/09 3.9 WARFARIN
4/10/09 3.2 BASELINE
4/15/09 4.3 WARFARIN

Are there any medical reasons why it would do this? Thank you for your input it is appreciated. I started checking my INR closely when I got bruises on my feet and hands. I did have a full blood count done.was normal..........He did blame the Warfarin........
I do have Arthritis in my hands, feet and back. Yes I am OLD, would the Arthritis make this differance? Just trying to find an answer, I thought I had the Warfarin figured out!!

Are you retaining water? Swollen ankles or legs?

 

[Jackie]

My right hand is always swollen, blamed on Arthritis, but I'm not sure. This started right after surgery while in the hospital. I think is caused from all the IV's I had. My left foot swells but that too is blamed on Arthritis. My ankles swell some times but the Doc seemed to think they are OK.

 

[Ross]

My right hand is always swollen, blamed on Arthritis, but I'm not sure. This started right after surgery while in the hospital. I think is caused from all the IV's I had. My left foot swells but that too is blamed on Arthritis. My ankles swell some times but the Doc seemed to think they are OK.

I'm thinking you have some congestive heart failure going on and because of it, your blood is diluted with excess waste and liver congestion. This slows the metabolism of the warfarin down, increasing the INR. I assume your not taking any diuretics? Might be worth having your Doctor run a BMP blood test and take a look at your creatinine and other kidney chemical output.

 

[Jackie]

Thank you Ross. I will check into it. I have an appointment with my Cardiologist on Monday.