Why low doses?

[MarciaB]

Hey guys,

I haven't fished around in this forum much (yet) so my answers may be here somewhere. My question is, does coumadin build up in your system somewhere? I am curious because they had trouble getting my INR up at the hospital, I was on 7.5 mg the last two days plus Lovenox shots (fun times). The day I was let out I was at 2.0 (I'm supposed to be between 2.5 and 3.5) but I was told to take 2.5 mg/day. Two days later my INR was at 1.8 and I was back to the shots (given by myself this time )and an increased dose of 5 mg. Two days later I was up to 2.6 but left the coumadin clinic with an alternating 2.5/5 mg. dose.

I don't understand why they keep lowering my dose when I'm either low or just right. I'm new to this stuff, so I didn't question the nurse, but I'm going to be really upset if I'm back to the Lovenox shots after my Tuesday appointment.

Does anyone know why they are doing that?

Marcia

 

[Guest]

Keep track of your daily dose.

Total the last 7 days.

If you are less than 0.5 units below the desired range you should increase by the equivalent of one day's dose. Example: Your range is 2.5 to 3.5 and you are at 2.1. If you took 35 mg over the past week, you should increase to 40 mg/wk.

If you are more than 0.5 units below the range you need to increase by 1.5 day's dose. Example: Same range byt your INR is 1.9. You took 35 mg/wk, increase to 42.5 mg/wk.

The same applies if you are too high, only reduce by the same amount.

If you haven't already, please look at my website www.warfarinfo.com There are over 200 pages of answers to your questions.

 

[Ross]

Follow Al's advice. What is particularly hard is when you first start taking it. Between your body recovering and all the other things that affect your INR, it makes for a bumpy ride. It usually takes a month or so to get things fairly even keel. Why they would change your dose if your in range is something I would question very hard. They should leave it alone and retest in a week.

If you stick with Al's advice, you should be therapeutic and manageable much faster. Some places plain don't know how to manage Coumadin. It's not surprising, it's shocking actually!

In my case, I take 45mg per week which is alternated 7.5 sun, 5 mon, 7.5 tue, 5 wed, 7.5 thur, 5 fri, 7.5 sat. On my last test I was 3.7 with no change is dosage. Monday is my testing day and if you look at the schedule, I have 2-7.5mg doses the days before testing day, so naturally it's a little high.