Yikes...1.7!!

[Sherry]

Just had my blood checked this afternoon after being on 1000 mg of an anti-inflammatory (Relafen) for this ongoing back/shoulder pain. I've been on it for five days, and my coumadin nurse was convinced it would be on the high side, so like an idiot, I ate a big salad for lunch. Went in at 3:30, and wouldn't you know it, it was 1.7 Geez, I can't get that number up for anything. She gave me a lovenox shot and ordered me to up my dose by 7 mg. today and tomorrow and come back on Thursday. (I normally take 45 mg. per week.)
Guess I just needed to vent. We were both convinced that a high dose anti-inflammatory would take me up. Who knew...

Anyone have any experience with this drug?

 

[LUVMyBirman]

Hi Sherry,

So sorry to hear it It's frustrating.

Sounds like you and I are the 'fast metabolizer' types. Everything that should make my INR go up....opposite.

Feel with you on the Lovenox. I have been giving myself injections x2 daily since Saturday. All in preparation to have my tooth extracted tomorrow. Just could not convince anyone to permit me to stay on the Coumadin.

Looks like we will be in the same boat here for as long as it takes to rebound.

Hope you can get your INR to turn around soon!
Take care.

 

[Guest]

The only reference I could find to relafen and warfarin was a mildly elevated INR in one person. There is no reason why it should cause your INR to go down.

One salad on the day of the test should not cause the INR to go down either.

Look for something that you have been doing different:
Eating that can of Bonnie's road kill (I know Sherry had one because she sat next to me at the dinner in Golden where these were passed out.)
Change in vitamins - even if the same brand did the ingredients change
More exercise
Change in the quantity of a medication such as Fiorinal that contains an interacting drug
Any possibility that you forgot warfarin over the weekend

 

[Ross]

I'm thinking bogus test result!!!!

 

[LUVMyBirman]

Had another thought, on a personal "ladies" level. Hormones! I recall you mentioning low INR's recently. Look to see if they are around "that time" if you catch my drift. Trying not to get graphic...but I usually see an increase in INR at that point. You may be working in reverse. Something to consider. I have noticed that women on Coumadin prior to menapause tend to have wild swings in INR's from time to time.

 

[Sherry]

Hey, Gina. Good luck with the extraction. I bet you're looking forward to getting back on the big "C". You know, you may be right about the hormonal connection. That is occurring right now, as we speak. I'm going to mention that to her on Thursday.

Hey, ,Al. No, passed on the roadkill but thoroughly enjoyed watching you eat it I keep a pillbox, so there were no missed doses. The doc that put me on the Relafen also put me on a tiny dose (5 mg.) of flexeril, but that's not known to interact with "C", does it? I am exercising quite a bit more. Have joined a club and am exercising at least three times per week.

Ross, it could have been a bad reading. Don't know..., but I assume since it was done in the cardio's clinic, that it was fairly accurate. Guess I'll find out on Thursday.

Well, let's just hope this lovenox injection and the extra dosage tide me over.

 

[Guest]

Exercise is the most likely culprit. I see it a lot. When you exercise, you increase your heart rate. This means more trips through the liver for the blood. That means more exposure of warfarin to the enzymes that metabolize it. Therefore, low INR. I have seen it go as low as 1.0.

I had a letter to the editor about this published in the American Journal of Cardiology back in 1999. Nobody ever replied with a, "you idiot..." message. I am convinced that this is a true effect. My clinic used to be in the same big room with a cardiac rehab gym so I was well aware of how much my patients were exercising.

 

[LUVMyBirman]

Sherry. I was on a another muscle relaxer?? (name)?It did make my INR go down in the 2's!

Yes...can't wait to get back on my "C"! Starting tonight. It may take an extended period of time to get back on track. This is my experience when coming off. Going to order a refill of the Lovenox before I forget. Just returned from the lab. They wanted a draw before they will remove my tooth. Scheduled for 12PM

Hope you get all ironed out soon as well

 

[Sherry]

Gina, did all go well?

Gina, did all go well?

Gina, just checking, did all go well today? Glad you're back on your "C". Hey, did you check out Bonnie's thread? She got her's pulled without being taken off. Interesting story, huh...

 

[Sherry]

Just a followup to earlier post -- I was at a 2.9 today (whew...), so she (coumadin nurse) doesn't think the anti-inflammatory did anything. I must have been low to begin with: maybe the exercise, I don't know, but the neurologist who prescribed that Relafen wants me at a 4.0 because of the vision loss episodes, so I'm going to start dosing a little higher (46.5 per week) anyway. Hope that bumps me up for good.

BTW, Ross, what the heck is that new pic of yours????