inr

[jueanne]

I was admitted into hospital with thrombo phlebitis on the 18th of sept this year after a scan it was found that i had a dvt as well i have been on warfren now for 4 weeks and also been using 180 ml of enoxaparin injections a day my inr has been 1.1 1.2 1.1 and is now down to 1.0 any advice on what im might be doing wrong . i take blood pressure meds thyrozine lansoprazole i have sleep apnea take anti depressants and use inhalers apart from that im healthy lol and im 52 .

[Rellim296]

Hi jueanne and welcome to the whacky world of warfarin!

I assume that your doctor has taken all of your medications into consideration. Just persist for the time being because you probably aren't doing anything wrong. It can take a while to get warfarin sorted. Lots of things affect the INR level and some things make it go up (alcohol, losing weight and some foods) and some make it go down - mostly green veggies. The knack (I'm told) is to eat the same sort of thing most days and not to have a lot of greens one day and then none for the rest of the week. You don't need to avoid anything except cranberries and grapefruit, but it's best to be moderate and consistent. Eat what you enjoy and let the warfarin fit in with your lifestyle and metabolism. Just because you still have a low INR is no reason to cut down on greens.

Some find it really easy to have a level INR, others find it difficult to achieve stability. Some people don't need to take much warfarin. The usual dose is between 3 and 9 mgs a day, i.e 21 - 63 mgs per week. Quite a few people take more than that. At my GP surgery they have a lady who takes 18mgs a day and another who takes 1mg every other day. It's really personal. Good luck!

[jueanne in reply to Rellim296]

thanks for your advice im on 4mg at the moment and the doc is putting it up every week .

[Rellim296 in reply to jueanne]

I started on 5mgs and it was soon up to 7mgs, so (as Bob says) it's your warfarin clinic who need to get it right.

[BobD Volunteer]

It is not you doing anything wrong it is the warfarin clinic! Surely they are raising the dose each week?

Bob

[jueanne in reply to BobD]

i have had my dose put up by 1mg evet week im now on 4mg

[BobD Volunteer]

In the good old days they started you on 10mg a day for three days and then started checking and reducing till they got you stable. This modern idea drives me to distraction as fiddling about at that rate will take ages to get you in range. The actual dose is not relevant and some people may need to be on 10 or 13 mg whilst others may only need 4 or 5 but until you get into range they don;t know what group you are in. It is all about ow our bodies metabolise the drug and we are all different.

You will get there in the end but don't beat yourself up as it isn't your fault.

Bob

[Offcut in reply to BobD]

I second that I was on 10mg to start and then dropped down. I have been on it since 1992 and this last few months it has gone a bit starnge and unstable. I mainly took 4 to 4.5 I am on 5 to 5.5 a day to get my back up.