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If on warfarin long term and usually your INR is stable, how often should INR checks be made.

Blooto profile image
13 Replies

I think INR checks should be made every month, however my local hospital was going to check mine every 12 weeks!, surely this is too long?

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Blooto profile image
Blooto
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13 Replies
Beancounter profile image
BeancounterVolunteer

Hi Blooto

Interesting thread, I am stable and on 6 weeks, and I suppose if there are no changes in between then why not 12 weeks, but when I was in France this summer and had to see a doctor, I told him I was on warfarin, and he told me the maximum length between testing in France was 4 weeks no matter how long you had been on or how stable you were.

The question I did not ask, was why? and I suppose what are the risks of leaving it longer?

Take care

Ian

tk11 profile image
tk11

Buy a tester yourself then you can be confident and have the freedom to choose. Have a look on the Roche website.

Blooto profile image
Blooto

I think the answer is that it must be safer to check monthly as INR can change for many reasons i.e. alcohol, new meds, change of diet etc etc. Longer periods between checks in the UK are due to trying to saving money and lack of staff, which is a false economy if more people have a stroke.....rediculous!

Marion62 profile image
Marion62

My GP says 12 weeks and doesn't do additional tests for change of medication either. He said it is not necessary.

Marion

Dodie117 profile image
Dodie117

Since getting my own machine I am testing weekly with hospital tests every 8 weeks. I have instructions to ring the hospital if it goes over 4. I am finding a lot of fluctuation on weekly tests. I go over 3 on a regular basis and then eat a portion of spinach and sometimes reduce warfarin dose if it stays high. I think this is due to eating less green veg over the summer months so need to be more consistent in my diet.

BobD profile image
BobDVolunteer

I am on 84 days which is an odd number but set by the computer program at the surgery. I think the point is that as I mentioned earlier INR is such a vague measurement and changes of diet yes they can affect it quite a lot, but if you say monthly then why not weekly or daily because things can change that quickly. If a patient is stable on a regular basis then checking at any regular period will at best catch a trend rather than peaks and troughs. I have been eating salad green such as watercress and spinach leaves more over the summer so may have dropped in and out of range but don't worry too much about it. If I go back in October and my INR is below 2 then they will put me on shorter checks till I have been stable again for a month or so.

Bob

Maitha profile image
Maitha

I'm on warfarin since 13 years , most of it my INR is stable where I used to have blood test every 4 weeks

Unless major changes in my lifestyle just like changing my diet , traveling , taking another drugs , in those cases I do it within 3 days and keep monitoring till stable again

Mjs-l profile image
Mjs-l

I have mine checked every month.

MarkS profile image
MarkS

I check mine with the Coaguchek every week. I'm surprised more people don't get one, they're so convenient. And what price to avoid a stroke?

Offcut profile image
Offcut

I have been on warfarin a long time and I am when stable 6 weeks but was not so long ago every week as it went very strange and could not find out what was so different. Then when it looked like going to some sort of normality 2 weeks for 3 months now my next is 4 weeks but still average 3.4

smw112 profile image
smw112

When I started on warfarin in July I had to go weekly. I asked if I would always have to go weekly and was told that once stable you only need to go every 12 weeks. My next visit is a 6 week one so am getting there!

It IS too long. INR's can change dramatically within several days esp depending on diet. Being checked every 90 days gives your INR too much time to bounce around before the next monitoring can pick up a problem or indicate a dosage adjustment is necessary. Is there a way you can learn to do your own checks at home? . Many people do. I check mine weekly, call the result (or go online) into my coumadin nurse and discuss my dosages for the coming week. Sometimes it's the same, sometimes I may be advised to take a half pill for one day rather than the whole. Look into it. Your doctor orders it. I'm in the US and my machine is 'loaned to me' at no cost with strips and lancets mailed when I'm getting low. I've read on this forum that in the UK the machine is bought so cost would be a factor. Either way, 3 months is too much time to not know if your INR is way out of line. Just my opinion but I would not accept this level of care. Take care. irina1975

robert7 profile image
robert7

Mine was checked every 2/3 weeks. Which was just as well because my INR went to 13.5. And had to have vit k in sugery

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