My INR level not reached it's target, should I be worried?

Hi, very recently had a DVT following a fracture of my ankle. I don't know if I am worrying too much but my INR hasnt hit target yet (after 3 1/2) weeks. My target it 2.5 - 3. It has been around 2.2 for over a week but went down to 2.0 yesterday. I look at this as a sign of the clot dispersing but dont feel confident now. Spoke to my INR nurse who couldn't really help.

Should I be worried and get a second opinion or is this quite normal?

6 Replies

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  • Hi Oggie. Variations of 0.2 INR from day to day are not uncommon and probably don't give any cause for immediate concern. It probably does not signify anything about the state of the DVT but is probably more to do with what you had to eat or drink yesterday.

    You ought to be up to the target range by now though after 3 1/2 weeks which suggests that your daily warfarin dose still needs to be a bit higher. I am surprised that the INR nurse couldn't offer any help about that, especially if she is the one deciding on your daily warfarin dose. If it hasn't progressed above 2.2 at your next test I would challenge her for an explanation why or ask for a second opinion then.

    I am not a doctor however, simply another patient like you so if you are really concerned you should phone your GP and get his opinion. All the best with it.

  • Many thanks for this. To be honest only had two visits to this INR nurse and without being nasty she is new to the dept and I don't think understands. She does however, telephone her boss to check the warfarin levels she is recommended. However, going to a different clinic next week so hopefully will start to feel more positive.

    Thanks again, appreciate feedback from somebody who understands

  • I wouldn't worry, as long as you are over 2, you are anti-coagulated. Following a DVT after breaking my ankle, it took 3 weeks for me to reach my target inr.

    See what they say at the new clinic down"t be worried about asking :)

    I've now been on warfarin for 20 years, inr changes for apparently no reason (what you eat / drink can affect it) :)

  • Hi Oggie

    I have been on Warfarin for 4 months now, it took me 3 weeks to get into therapeutic range, and I have only been in range 55% of the time based on my blood tests. Like you I pestered the nurse at clinic to try and understand this phenomenon, but have decided that Warfarin is not a robust drug, and its efficiency is influenced by many factors. The personal experiences of people on this site helped me try and understand, but I haven't worked out what affects my INR yet. Regular blood tests are necessary, I am slightly more relaxed about it all now, maybe being anxious is another factor which affects INR. Hope this weeks blood tests show an improvement for you, I go for mine this week and wonder what number it will be?

  • Thanks so much rainey999 and gel1,

    Sometimes I think I worry to much but knowing the consequences should the clot start moving I can't seem to help myself. To be honest, after finding this site only yesterday I feel a lot better about it all, having read other peoples experiences.

    I understand different things can change your INR but how on earth you find out what affects yours?? Only thing I have had differently this week is the application of some Nivea on my foot as my skin is extremely dry from the cast / bandages.......surely it can't be that?

    Gel1 I wish you look with your blood test this week too, lets hope we both see an improvement.

    Thanks again

  • It can be affected by stress, illness, broccoli, alcohol,.......... It is amazing how many foods can affect warfarin . the best thing is to be relaxed about it, get you checks done regularly and keep asking questions :)

    Having been on it as long as I have..... The main thing for ,me is that I don't let it run my life :)

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