INR still 1.5

Hello,Second visit to Warfarin clinic dosage now increased from today to 6mgs daily as although been on it for three weeks INR is still 1.5...and has not altered at all...Is this normal the Nurse was very surprised as the dosage was increased last week to 4mgs from 3mgs the previous week...I realize I asked a similar question last week I do apologize so please forgive me.C

[BobD Volunteer]

Hi Caromia, Don't worry you will get there eventually. Some clinics start you low and creep up on it which I personally don't like. I was started on 10mg for two days to get me up there and then eased into the range over the next few days Now they seem to go for the slowly catchy monkey way and do it over a long period. I know which I preferred. 4mgs is still a very low dose. I take 4.5 most days and 5 one day a week to stay at between 2 and 3 but know people on 10+. It depends a lot on your metabolism and diet. Provided that you keep your diet regular and don't binge on anything you should be O K once you stabilise.

BobD

[Hidden in reply to BobD]

Thanks BobD...Sat there in the clinic for a couple of hrs all clutching our little yellow books would much preferred to be clutching my passport at Liverpool airport.,,,,,C'est la vie ........Hope you are keeping well...C At least I am on the 'stuff' now, eventually!

[Terjo]

One or two grams a day were all I needed to keep me between 2 and 3 inr . I was started on 10mg in hospital and then 1mg for the next week after that the clinic took over and then gradually eventually ended up in hospital with a inr of 5 and a liver bleed.

Better safe than sorry. Everybody wants to do the best thing but it is very individual . I bought an inr meter to measure my inr myself before i had the cardioversion, Terjo

[Hidden in reply to Terjo]

Hi Terjo...I had been on 4mgs since last Friday and increase of 1mg from the previous week but hadn't made the slightest difference still 1.5 ....I had been for a swim and a sauna before my appointment could that have altered the reading, The nurse took the reading twice as it went hey wire the first time,,,The dosage has been increased now as from today 6mgs/4mgs alternative days...Which is a big increase I think....but I am sure they know what they are doing....C

[Hidden in reply to Terjo]

Hi again Terjo...I apologize didn't thank you for you response....In Drama Queen mode at the moment...C

[Maitha]

I'm on 5.5 mg warfarin since years and my INR is usually 2.5-3 nearly stable

Doctors used to tell me that I'm lucky since mine is nearly stable , of course in case no other medication

Since in case of antibiotic it used to go over 4

My diet usually stable , I don't like major changes in food , and Im aware of the list of food which may effect INR level so I'm very careful

Just small advise don't trust doctors input 100% when they said about a medicine that it is impossible to effect INR level since everybody reacts in different way , and it may effect your other medication , and may effect also your metabolism as well which means INR again, It is all connected and INR is very sensitive

It is recommended to have warfarin alone , not with meals to avoid any possible reaction

Maitha

[Hidden in reply to Maitha]

Thank you Maitha for your advise...I hope you are well as I believe you have been quite poorly this past week.Regards...C

[Langara]

Hi - it seems that getting one`s INR balanced is a bit of a lottery. My INR crept up to 2.3 then a week later, without any change to my eating and drinking habits, dropped to 1.8. This week an increase to 7mg for 4 days and 8mg for 3 days raised the INR to 2.1. Taking bets on what the next test will show! Just hoping it will start to even out in the next 3 weeks as I am off to Rhodes for a couple of weeks, and I don`t want to spend the whole time worrying about my INR and whether another portion of taramasalata is taboo!

[Hidden in reply to Langara]

Hi Langara,Good to know someone else is up and down like a fiddlers elbow. I suspect it may have something to do with eating habits,,,Although I trying to be more disciplined....

Have a great in Rhodes and as long as the Taramasalata is not washed down with Ouzo or Souma I guess you will be fine...Lol C

[jeanjeannie50]

Hi Caromia, you are not alone. For the last 8 months, since starting warfarin, I've been back and forward to the docs just about every week for a test as my INR result goes up and down too.

I was on 4mg daily and it went up to 3.1 and two weeks ago doc reduced it to 3mg and it went down to 1.6. Started on 4mg again last Tuesday and yesterday it was 1.8 told to stay on 4mg daily and to go again next Friday. It's shame they don't do a half mg tablet. I don't like taking 4mg as last time when it went to 3.1 I developed red blotches just above my ankles. Mind you hearing the high dose some people on here have to take I'm now feeling grateful I'm only on 4mg.

Bob, how do you take 4.5mg daily ? Do you cut a 1mg tablet in half?

Langara - You lucky thing going to Rhodes, it's so beautiful.

Maitha - Is your heart in normal sinus rhythm now?

Jean

[Hidden in reply to jeanjeannie50]

Thank you Jean good to know I am not alone in this,,,I somehow thought Ihere would be some sort of complication...Just wonder what the next step is if INR cannot be stabilized I can see the dosage go up and up every week at this rate...Its exhausting this focusing my attention on myself so much !!! Thank you and take care...C

[BobD Volunteer in reply to jeanjeannie50]

Hi Jean I have 3 and 1 mg pills. My dose is actually 4.6 daily but given as 6 x 4.5 and one day at 5. The days I take 5 I have 1x3 and 2x1 mg pills. The other days I either take 1+1/2x 3mg or 1x 3,mg and 1+1/2 x 1mg. The pills all have grooves for splitting so no problem whatever I need. I break them in half with my fingers. I am really not precious about it and usually take my meds sometime between about 5.30 and 7.30, usually with a glass of wine! ALL meds need to be taken thus in our house. If I am feeling a bit weird or getting lots of ectopics I do leave out the wine. lol

BobD

[Dottilind in reply to jeanjeannie50]

Hi Jean, you mentioned that you wish there was a 0.5mg tab. Well I on 2.5 daily and they are avaiable at chemist through doctor and are white in colour. Ask your GP. Dot

[jeanjeannie50 in reply to Dottilind]

Thank you

[llamudos]

I also seem to have drawn the short straw when it comes to warfarin. I take 11 mg and 12 on Wednesdays . I put it down to my diet of mainly veg fish and chicken and keeping fit. I am not happy with the month long gaps between testing my INR . as I feel I am not stable .again this week I have woke up with blood in my mouth. So I have cut the warfarin down to 10mg which seems to sort it out . I done this because it is still three weeks until the next blood test and I am to worried that I have gone to high.

[Hidden in reply to llamudos]

Hi,I understand were you are coming from with the veg...I mentioned to the nurse that I eat mainly fruit and veg but she didn't comment or say that's why the reading had not changed...Where did the blood in your mouth come from would it be your lungs or maybe trickling down from the back of your nose...To see blood must be a great concern and its a long time before your next appointment at the clinic...Maybe you should ask to be seen earlier? C

[Beancounter Volunteer]

Hi Caromia,

It's really hard at first to get in balance, some people seem to just immediately get above 2 and stay there, and then some (like me) took me 13 weeks to get anything like a balance, my antio-coag nurse was tearing her hair out I think, on the same dosage of warfarin I was 2.3, 3.1, 1.9 3 weeks running, but it just seems to take time for our bodies to get used to it for some of us.

I went from weekly testing, to two weekly (twice) then monthly (once) and now six weekly and it's pretty stable between 2 and 3.

The dosage is really quite irrelevant, be it 4mg or 10mg, it's the effect that matters to be honest and we all seem to differ in that.

Stick in there, you will be fine

Ian

[BobD Volunteer in reply to Beancounter]

You are quite right there Ian . Doseage is irrelevant. It is the result which matters. INR is such a complex thing and most people don't know the half of it. Testing must be consistent and done at the same lab or machine preferably at similar time and conditions. Coagucheck machines will often give different results to blood draws and one lab will be different to another for the same sample. Age of sample is another variable. As an engineer I found this lack of consistency quite troubling but have been persuaded by explanations that it is all within medical tolerances. There are people who know far more than I about INR who still don't fully understand it so best to accept what we are told and meekly take our pills. For what it is worth I am on 84 days between testing.

BobD

[Hidden in reply to Beancounter]

Hi Ian,I seem to remember you saying once you had a change of lifestyle and have a stable diet possibly that is a factor...I am concerned that the larger the dose then there is more likelihood of internal bleeding...

I seem to be doing nothing but complaining about the medication that I am on ...I am sorry but I don't seem to be able to suffer in silence try as I may...Is there ever a time when it becomes apparent that Warfarin does not meet ones needs and if so what happens then....? I will have to stick it a while longer after complaining on only being on Aspirin and it took me months to convince my GP and Cardiologist .....Thanks again Ian.....C

[Beancounter Volunteer in reply to Hidden]

Hi Caromia

I am not a medical professional, but my understanding is that the risk of internal bleed would be matching your INR, not the warfarin dosage, if your INR were 5 or 6 then I can understand your concern, but I've certainly been in the high 3's without any problems and as you say you're still on 1.5. Dosage really is irrelevant, it's INR that matters.

I do understand the fears about warfarin, but honestly for most of us it just takes time to settle down to your physiology and diet, and then you will wonder what all the fuss was about. Promise

Ian

[Hidden in reply to Beancounter]

Yes Ian it is making sense now.So its not the high dosage of the Warfarin that induces the bleed but the INR being higher than the 3's...Took sometime for the penny to drop but got there in the end....lol c

[Beancounter Volunteer in reply to Hidden]

Great Caromia

One quick word of caution, don't get hung up about 3's many of us go way over 3 regularly, without any problems. Of course depends on your lifstyle. and you certainly bruise easier when higher, I can't find an absolute guide to say just how high is bad, but most places say 5's and 6's, and there are some conditions (Not AF usually) where they want patients to be up to 3.5 to 4 with warfarin.

Have a great weekend, and let's hope the rain stops tomorrow and I can go out and get my overgrown lawn back looking less like an uncut hay meadow.

Ian

[Offcut]

I am on 4.5 or 4.5/5.0 alt days for most of my warfarin life since 1992. but for some reason I am having to go every 2 weeks and have been 3.8, 2.1, 3.7, 3.7, 3.4 INR I did go up to 5.6 when I was on one of the lol's and flecanide some years back. I have a boring diet with a rare treat of a good curry.

It does take a bit of time but I think you are getting the best way of finding it

[Hidden in reply to Offcut]

Hi Offcut...I am consumed with this now the Bisoprolol and Flecainide have taken a back seat to the Warfarin, planning meals and looking at food suspiciously...A meen curry not on the menu tonight though....maybe tomorrow.!!!.....Hope you are keeping well.c

[Terjo]

Just goes to show how different we all are! That's why I think statistics are so misleading. It's very important to remember this. Good luck Caromia I hope you stabilise soon and have a good trip. Terjo

[Hidden in reply to Terjo]

Thank you for your concern...C

[MrGed]

pain in the arse warfarin INR check ups I used to be on 8mg for ages before it stabilised having to go to clinic every week , waited ages for the right figures for cardio version if your INR level is down day of CV at can be cancelled also

[Hidden in reply to MrGed]

Hi MrGed...When you say used to be does that mean you are on a lower dosage now or are you on an alternative medication...

[MrGed in reply to Hidden]

hi caromia I had five cardio versions which all failed , then I went on flecinide therapy for a final try before going for ablation , no one expected it to work but on my sixth cv it worked , the only medication I am on now is bisiprolol , been in sinus for nearly three years now , unfortunately now I think my luck is running out and im dropping back into AF , getting loads of eptopics etc used to be on loads of meds though but managed to taper it down to one

[Hidden in reply to MrGed]

Hi Again MrGed,sixth time lucky and down to the Flecainide....Don't say your lucks running out MrGed just a minor hic up ...A kick up the AF's butt is all that's needed ....Keep smiling....C

[MrGed in reply to Hidden]

ooooo yes I will kick AFs butt , ill stick a couple of kicks in for you , and all other AF sufferers , enjoy weekend

[MrGed]

taking flecinide as pill I the pocket as necessary

[Terjo]

You're so lucky, I've had just one cv and am on Flecanide 50gm three time a day. I wobble a lot and have had three AFs this summer,just hoping it settles down.

Good luck. Terjo