Your thoughts on new coumadin dose....

[Jiddo]

Hi All.

My dad got his INR taken yesterday morning and it was 2.0, which is within range (2-3). Because he is on the low end of the range and because a couple of weeks ago his INR dropped to 1.7, the pharmacist recommended adding 2.5 mg to his dosage this week and possibly on a go-forward basis (from 75 mg/wk to 77.5 mg/wk).

This is a 3% increase, which sounds reasonable to me. In my last post, it was mentioned that my dad's dosage may need to increase on a regular basis because he is more active these days.

I just wanted to get your thoughts on the increase. The pharmacist wants my dad to re-test in 10 days (August 16th) so she will get a full week to evaluate the effects of the increase.

Your thoughts?

Thanks.
Jennie

 

[Ross]

It's conservative, but may be all he needs. I'd of went a little more, but see what the next test holds.

 

[Ross]

Well no, were not disagreeing in anyway. I too, feel he should be closer to 3.0 then to 2.0, but anything in range, at this point, is acceptable.

 

[Jiddo]

Thanks for both of your thoughts on this. I understand the reasoning for my dad to be on the high end of his range. We'll just have to tweak here and there to see what works and gets him where he needs to be.

Thanks again.
Jennie

 

[Karlynn]

It's step in the right direction. If his test in 10 days is still hovering around 2, I'd do another increase again.

He's so blessed to have you help him out with this.

 

[Jiddo]

Hi guys.

So, just an update on my dad's INR after he re-tested yesterday. He is still at a 2.0, even though we upped the dose 3% from 75 mg/week to 77.5 mg/week last time around (10 days ago) because his previous test was also 2.0.

I have not spoken to the pharmacist yet but I am thinking of increasing his dose by another 3%. He is currently taking 10 mg 4x/week and 12.5 mg 3x/week. I am thining he should go 10 mg 3x/week and 12.5 mg 4x/week.

I don't know of anything different my dad did this past week that he didn't do the week before. I know my parents stopped obsessing about his diet, though my mom is still cooking his meals but allowing him more freedom to snack throughout the daily (on mostly fruit).

The good news is that he is in range, so I am happy about that. I just want to see him closer to the 2.5-3.0 range.

Any thoughts/feedback is appreciated.

Take care and Happy Friday.

Jennie

 

[ALCapshaw2]

SMALL changes for "range tweeking" work well for me.

My weekly dose is quite a bit smaller and we (whichever CRNP I get at my Coumadin Clinic and I) dicker over whether to go up (or down) by 1 or 2 mg / week which works out to roughly 4% or 8%.

Other than a couple of False Tests (questionable finger test monitors which are being 'studied'), I've never been grossly out of range in several years.

Bottom Line: I agree, another 3% increase and test in 7 to 10 days sounds like a good plan. If it doesn't go up, repeat the same step size and test. Don't forget, as your father's activity level goes up, so will his metabolism and therefore he will likely need SMALL adjustments to account for that change.

'AL Capshaw'

 

[Ross]

Like I said, it was a conservative amount. I would have gone 10% higher the first time. 3% for me, never shows any increase, but now your talking a total of 6%, so it should at least be 2.2 on the next test.

 

[Jiddo]

Thanks for your responses. I just spoke with the pharmacist and she said my dad's INR was actually 1.9 and not 2.0. This is the second time I received mis-information on my dad's INR (when speaking with someone outside the clinic). In any case, we agreed on still increasing my dad's dosage from 77.5 mg/week to 80 mg/week. We are going to re-test in another 10 days, on 8/27.

Thanks.
Jennie

 

[Ross]

I don't know, maybe 12mg per day would be better. Guess we'll see.

 

[temp69]

sounds reasonable to me.

sounds reasonable to me.

if you can home test, get it going because it's wonderful and convenient.

good luck!