INR again

So my Dad increased the dose to 3mg for 2 nights then went back to his usual 2mg. The INR was checked again and was 2.8. He continued taking 2mg for 4 nights and it went to 2.3 and today after 2 more days of 2 it was 2.1. His GP always says just take 2mg regardless of what it is, but other GP's have suggested alternate amounts. The anti-coag team at the hospital I work at say the same thing, that he may need to alternate 2/2/3 or 2/3 to account for the drops. They say there is a formulae to work it out, does anyone know anything about a formulae? It is something like the amount of Warfarin taken in a week and the INR results but I don't know anymore specifically. I don't like self dosing but sometimes you have to ensure the level is correct.

6 Replies

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  • My dose is altered by .25 or .05mg on a daily basis until I am in range. Much easier than having different doses on different days. As I self test I can see a difference in a couple of days or less.

  • I think self-dosing is the way to go. Some medics probably wouldn't agree, there's still a very paternalistic approach. In your Dad's case I'd take 2.5mg p.d. You can get 0.5mg tablets (the white ones) or split a brown tablet.

  • Emma, my INR fluctuated constantly all 6 years I was taking Warfarin and bloods needed to be checked on average every 11 days. This was done at my GP's where the result was fed into the computer which printed out my dosage for the next however many days, 2 to 3 weeks usually. The dose was different day to day. It was a bore but I was still able to travel for three months abroad by finding hospitals to check my bloods and emailing the result to my GP who emailed my dosage back to me. Recently my cardiologist changed my drug to Pradaxa, same dose twice a day every day. So much easier. But I would really advise against self dosing Warfarin unless and until you know for sure the INR is stable. Mine never was. Good luck with it and don't worry, the variation in your Dads INR looks to be within the bounds of safety.

    Tina

  • StClares......So,So much easier with the new NOACs than Warfarin. Mine was fairly uncomplicated compared with some of the people here...but..I cannot imagine having to get checks abroad and then e mail. to my GP. It is one of my dreams that everyone who wants it can be moved on to the simple life and an NOAC of their choice.

  • I think warfarin dosing is difficult when you are only taking 2 or 3mgs per day. Quite a lot of people take 9 or 10mgs and any adjustments in dose are less significant at that level.

  • Yes I hadn't thought of that. At least that is one advantage of taking bigger doses! X

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