INR

When I was first on warfarin I reached my therapeutic range and stayed there fairly easily. Then I changed to Dabigatran and then I was put back on warfarin for an ablation. I have had to stay on warfarin because I have a blood clot. I should have been in therapeutic range 3.0 - 3.5 since beginning of September but I have only achieved that for a few days. Yesterday I had another check and I had gone down in a week from 2.6 to 2.1 even with an increase in dosage. What is going on?! I am really concerned that I will have a stroke.

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  • I self test Barbara and if mine falls a bit low I avoid green veg for a day or two and that usually does the job! Also ask your clinic about increasing doseage if you feel it is needed

    I'm not sure why the range has been set higher but 2.1 should be ok re stroke possibility.

    Were you told how long the clot takes to dissolve? I know we often have clots which are only noticed on TOE so try not to worry too much

  • Thanks for reply Rosy G. The higher range is so that the clot does not propagate. It will take up to 6 months to be reabsorbed my EP advised. Sound advice about avoiding greens for a while but I try not to alter my diet at all, so I will think on that!

  • My INR seems to lag behind the dose changes by quite bit. I've had it go down even with an increase in dose. But then it'll start going up after a time, not sure how long but not days more like a week or more? I don't self-test so not so sure as Rosy. I do wonder whether some of the test results are spurious as well as they seem to make sense over time, but not each one. I've been on the same dose and the same diet for ages and my INR has gone 2.2, 2.4, 2.6, 2.8 ...... then 2.2, why? ..... then a few weeks later 3.4 !!! When I got the 3.4, which I was half-expecting because I was very suspicious about the 2.2 result, I had the dose reduced.

    Koll

  • You and me both, Koll. A month ago my INR was 2.8, two weeks ago 1.6 and latest 1.9 all on the same dose and without any significant diet changes. Which is why the arrhythmia nurse has said I would be an ideal candidate for a NOAC! I'm going to talk to my GP about it on 21st. I've been on 2weekly tests for 14 months now!

  • Hi Barb, how about getting an INR monitor? For £300 you get peace of mind and if you stay in range 70%+ of the time, the best stroke prevention available.

  • Yes, I am using one MarkS as well as frequent GP visits. Just can't get in range.

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