INR 1.9

[jeanjeannie50]

Despite my INR being 1.9 this morning I've been told to continue taking the same dosage of tablets and go back in two weeks. Is it me or does this seem wrong? I'd have thought they would have at least upped it by 1mg a week.

[Wightbaby]

I would have thought so...when mine was 1.8 it was upped by 1mg a week..2 weeks is a bit of a wait...say it drops more?? What was it last time?

[jeanjeannie50]

My last INR on 27th May was 2.6. I've stopped taking Amiodarone since then and think that's why it's dropped. I did tell the nurse this when I saw her this morning and she wrote it on my record. Hmm, I think I will ring my doc in the morning and ask his advice (he wasn't in today, so another doc has suggested I keep on the same dose). My GP is great and I trust what he tells me 100%.

[dedeottie]

Yes I would ring your usual doctor. I have lowered my dose of flecanide and over the course of 2 weeks it's come down from 3 to 1.6 so today I took an extra mg and will ring the nurse in the morning. I have my own machine which helps and although I'm only meant to ring in my results every 8 weeks they are fine if I ring sooner. I'm not meant to adjust my own dose but I have done from time to time by very small amounts. Sounds like it could be the altering of amiodrone.x

[Rellim296]

One minute they tut and huff and puff if you say you didn't stick to your dose by just the tiniest wee bit (I only did it once it as caused so much fuss) and the next they are amazingly casual and don't seem the least bit keen to push your INR towards 2.5 and send you off for weeks. My feeling is that if one's INR is under 2.2 the dose should be going up, but it doesn't seem to work like that. Do they not think that being in the low 2s or under might be a high point and one might be way down below for much of the time?

[Hidden]

Calling your doctor sounds like a good idea - it's been going down rather than up, so keeping on the same dose would seem unlikely to change that...

[AnticoagulateNow]

I suppose it depends on what your reading was the previous time. Are you currently going up/down/static? However, why not ring the warfarin clinic (number should be in your yellow book) and tell them of your concerns? Ask for their reasoning. If their response is not completely satisfactory, contact the stroke clinic at the same hospital and tell them you are worried. They really will act on your behalf! Then, if it were me (I can't possibly recommend this to you), I'd pop an additional 1mg and go for my next blood test in 7 days. No one should quibble about you going for an earlier than usual test.

(Sorry jean, didn't fully read the postings - 2.6 down to 1.9 needs arresting).

[Hidden]

This sounds quite normal thing to do to me. My clinic would only have raised my warfarin by one quarter mg daily but as I am self testing I would do so myself. Phone the clinic or doc and remind them of your change of meds. Glad you are off the dreaded Amiodarone Jean! I am now on Disopyramide and seems to be doing what nothing else would do I.e. working! Sandra

[jeanjeannie50 in reply to Hidden]

Hi Sandra - I took myself off of Amiodarone. I forgot to take them for two days and then realised that my heart wasn't doing it's strong and annoying thumping. Having stopped it totally all is calm with regard to my heart and I have been able to forget about AF. Interesting that you are now on Disopyramide and I'm pleased to hear that it's working for you. Is that a new drug as I've not heard of it before?

[Hidden in reply to jeanjeannie50]

Hi Jean -- no, Disopyramide is quite an old drug & rarely prescribed, so I am told. My EP said that I am the only patient that he has on it ( ??!! ) I'm not sure that is a good thing! I was on it 16 years ago & it worked then pretty well but was then unobtainable . Anyway it is working at the moment & will see EP in 2-3 months . I'm not taking too much notice about it on the internet otherwise I wouldn't take anything. Don't fancy any more ablations if I can help it. Well it's off to Somerset levels to stay at our favourite gastro/pub hotel for the weekend -- shouldn't get into too much trouble just for the weekend!

Regards Sandra

[Hidden]

G'day Jean,

No worries, this often happens to me. Last time was a few weeks ago when I forgot to take a dose one night immediately before a INR test. All my GP did was increase my INR test date frequency but maintain the dose and the following week I was back up to my normal reading of 2.6.

That said, this has often happened when I have NOT forgotten to take a dose too, when for some reason it has inexplicably changed., in such cases GP has maintained the dose and watches the test dates more frequently and more closely and it returns to its normal level. In my non medical, non scientific opinion its just part of the character of the beast I'm afraid. However, I do admit to tweaking my own dose at times but only by 0.5mg a week. That usually corrects it then I go back to my regular dose.

Aussie John

[Dadog in reply to Hidden]

I think that's right, AJ. I had a check last Monday and reading was down from 2.1 to 1.8. I owned up to missing my usual 3mg dose 4 days before and the nurse was OK with the reading and simply wants me in next week to check it's moving in the right direction. Any change from your regular life style, eating and drinking habits, etc. will throw your INR out. Nurse told me of a patient that loved asparagus and indulged herself when it was in season and sent her INR crazy for a while!

[jeanjeannie50]

Thanks for all your responses. I've rang my surgery this morning and asked if my GP can call me back later today. My problem is that if my heart starts racing it won't stop until I have a cardioversion and I have to wait six weeks with an INR of over 2 before they will carry out this procedure. So if my INR is low that will be six weeks of hardly being able to walk and feeling absolutely dreadful. I may well enquire about the new alternative anticoagulants as my INR has never really been stable, it's usually too high.

[lizwright]

I had this and I had a bit of a tantrum as I am obsessive about being protected by wafarin. I insisted in GP having a look at it and they did up it a bit.

[meadfoot]

Hope you GP calls you back soon Jean so you can feel better once you get his/her advice. I have been takeing a new anticoagulant for 16 months without issues. Ask when GP call.

[jeanjeannie50 in reply to meadfoot]

Thank you Dee. Which one are you taking?

[Salvatore68 in reply to meadfoot]

Hi I will have my first cardio version but have not started anticoagulant .

Which anticoagulant are u on ?

[jeanjeannie50 in reply to Salvatore68]

Warfarin.

[jeanjeannie50]

Have just spoken to my GP and he has said to increase my dose of warfarin by 1mg per week. I also asked him about the new anticoagulants and he said he would be happy to prescribe them for me and that his surgery prescribed more of this than another other in the south west. He was slightly concerned, if I did take them, how this would affect my having another ablation if needed. I will be speaking to my EP over the next two months so will see what he advises. It was nice to know that my GP will prescribe the new drugs willingly should I want to go on them.

[jondeanp]

I'm surprised your warfarin dose is managed by your GP. Mine was managed by an anti-coag team at the local hospital.

For info my penultimate INR was 2.7. I missed 2 days doses (10 days & 7 days) before my last reading and it had dropped to 1.9. I was surprised at such a change

[Rellim296]

I had to stay on warfarin for an ablation - could not move to apixaban.

[jeanjeannie50 in reply to Rellim296]

That's interesting. I think for now I will have to do the same.