Ok, so ive been on warfarin for the last 3 years (this is now the 3rd year)
The last time i went to the doctors for a blood check up was October 2015 and my INR then was 2.1.
I just went yesterday (20/01/2016) and it came up as 1.2
Now for the love of me I do not know what has caused it to decrease. Yes I eat vegetables, but no where near in excess, i eat a lot of jacket potatoes, tuna, cheese, sweetcorn, mayonnaise, chicken, rice, cucumbers, cereal - and thats pretty much it
This is very perplexing -
Written by
dranzer01
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Any one who read my recent posting about INR's, will know I agree with this!! Mine had gone back to 2.3 today (after 3.1 2 weeks ago)......don't think the nurse was very happy because I confessed that I had ignored the computer's suggestion that I drop the 1mg extra that I take once a week.....I was sure it would stabilise on its on, and this was because I have been on the same dose and VERY STABLE for the past 2 years, and the one time it went up to 3.1 before - no change in dose was suggested!!!
So they are keeping me on my old dose and checking again in 2 weeks.
Like dranzer1 I have no idea why they went up.......apart from going away at Christmas, so deviating slightly from usual diet!!
When mine dropped like that , which it did a few times, they then put me on weekly or fortnightly testing for while. Hope they do the same for you.
My GP aims for 12 week testing for me - I think that is far too long. He tells me it's in the guidelines. I'm at 8 weeks at present.
My initial view is that 3 months is far too long unless you self test and can carry out additional tests in between. I do self test and have gone as long as 70 days as instructed by my clinic. However, because I self test I have the option of carrying out tests myself in between and I don't tell anyone. Just a peace of mind thing.
How many times in 3 years have you been on 3 monthly tests ? How many times in 3 years has your INR behaved in this way ? Unless it was occurring regularly I would treat it as a one off and not worry. If it was a regular feature I'd ask my GP for more frequent testing and in this regard of course you may not have a clue because you would not have done any tests within the 3 month time period. My understanding from reading various NICE papers is they reckon INR testing of 2 weeks is sensible.
Last May my apixaban was working fine, giving me the best possible protection from stroke. It was still working to 100% effectiveness through October, and today, yes it's still doing it's thing.
I think anyone on long term warfarin needs a Coaguchek monitor. I test my INR weekly and it's always in the 2-3 range. A little high and I drop 0.5mg and v.v. Keep your INR in range 90%+ of the time and it performs better than the NOACs, including apixaban!
What is your target INR? This is usually expressed as a figure, eg 2.5, or a range, eg 2.0 to 3.0. In practice, this is a VERY tight range. Many people have swings well outside this range, without changing the dosage.
I am always more concerned about a low INR than a higher INR. The key question is, is this 1.2 a fluke? Was the testing right? A doctor told me, if I suspected a fluke, to insist on a retest the next day. Abroad, you can simply go to the next lab and try again. You could self-test with the Coaguchek.
If you cannot retest the next day, then what is the safe course of action? Answer: an immediate boost of 20% for your Warfarin for 2-3 days, then normal dosage. This boosting tops up the reservoir level, and you can go back to normal dosing. With Low INR you have a lot of margin with boosting -- it really is safe. Then you test weekly for 3 weeks. If you see that it again drops very low, then the reservoir level insists on dropping. It is time for a daily dose increase of around 20%. Again, test weekly.
Remember, you must keep your lower INR above 2.0 to have any protection. On the other hand, swings above 3.0 (up to 5.0) are inconsequential.
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