Whoops! Missed evening dose and then took full dose the next morning...

pem · May 9, 2015

Hi All!

Been a while since I've been on the forum - so greetings to my old pen pals.

I missed my dose last night and its been so long since that has happened that I forgot the protocol. So I took a full dose this morning. I see that I probably should have just taken a half dose this morning, and then resumed with the normal dose tonight. So now what should I do? Take the full dose tonight anyway, or a partial dose? I just checked my INR. It is 2.3 (my target range is 2.5 - 3.5). So is it okay to take the full dose tonight, or will I spike tomorrow if I do?

Thanks

pellicle · May 9, 2015

Hey PEM

I don't think it will make so much difference but if you are 2.3 now I'd just go on as normal. I doubt your spike would go much over 3.5 anyway. If you felt like tinkering try a bit less (30%) tonight and resume as normal.

I did a missed dose the other week and the fluctuations were as I anticipated.

Hope you are doing well

dick0236 · May 9, 2015

I agree with Pellicie,.....just go back to your normal routine tonite. Check it in a week and you'll probably be back in range.

pem · May 10, 2015

Thanks, guys. Knew I could count on you. I took 5mg (normally take 8mg) tonight. Will resume 8mg tomorrow night.

By the way, Pellicle, I did try running your model tonight to get some insights, but the resolution is 24 hours, and my situation required 12 hour resolution. Didn't take the time to modify, but might play with it tomorrow to see if I can create a continuous time version.

pellicle · May 10, 2015

Hey PEM

Just be aware that the model is ultra simple and is a guide. There are issues with it (such as it will calculate a zero INR which is meaningless, and has no buffering).

I usually run a 2 and 3 day moving average and the actual result sits somewhere between those three lines.

I also have never measured more frequently than daily and have not subdivided doses into 12 hourly. I would not be surprised if 4mg twice daily did not give the same result as 8mg daily. So I think interpolation is vexed.