AF Association
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Missed Warfarin dose?

Anyone who follows my posts will know that my INR's are pretty stable.

Now I am in a slight quandary, as I take 5mg every day and 1mg extra on a Tuesday.

I had my INR check on Tuesday a.m. and it was 2.6.

I am so cross with myself, because I was distracted in the evening and I just CANNOT remember if I took the extra 1 mg or not? I just wondered how crucial 1mg makes, one way or the other??

I DO worry about dropping below 2 and going out of range!

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Whilst being discouraged to offer medical advice I am pretty sure missing one 1mg tablet is very unlikely to cause you any problem.

I take 3Mg every day (My INR is very stable) and I have missed a whole day dose before and had no problem.

Don’t make a habit of it!!!

Pete

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I honestly think you are worrying unnecessarily . 1mg won't alter things much as it is the average amount in your body and takes time to change. If you are that worried take another as that won't hurl you out at the top end either. Remember up to INR 5 is not dangerous and we were once told by an expert that if it were him he would be aiming at 2.5 to 3.5 rather than 2 to 3 in order to rule out measurement inaccuracies.

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Ah Bob, you know me........"worrying unnecessarily" are my middle names....Thanks for your common sense reply...........I am cross with myself for being distracted. I am usually very vigilant with my meds.

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I wouldn't worry....shouldnt make that much difference.

I bought a pill box divided up into days so that way I know if I have taken my tabs as mind has started to play tricks on me.....nothing to do with age of course. So easy to get distracted .

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Sounds like a good idea....need something to remind me its TUESDAY!!!

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You're not alone !

Btw..its Friday😂

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Wightbaby , set your smart phone if you have one , I'm the only one that has a dumb phone ,for the time you want to be reminded ,even my simple old folks phone has a reminder thing that will go off when set for a certain time and keep it with you so you hear it LOL. See if that works .I thought I was the only one who forgot to take a pill .

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G'day Wightbaby,

Oh dear !

Don't worry, keep calm, carry on AND DO NOT TRY AND PLAY CATCH UPS !!! :-)

This has often happened to me (despite having an alarm app on my smartphone AND usually after I've been out partying trying to regain some of my lost youth !) and I've just carried on regardless and the next timeslot that I was due to take my warfarin I just carried on with the dose scheduled on that day and that time. No worries.

Yes, I know you are INR stable but this misdemeanour is not likely to send you into the naughty corner .......... at a guess if you had your Coaguchek device at hand you could deliver yourself peace of mind at the time of your next scheduled dose take an INR reading and check it. My guess, pure guess that it might show an INR of 2.4 if that.

You are unlikely to drop to 2.0 or below and even then it wouldn't be that significant unless it stayed there, which I am confident in saying it wouldn't.

Remember Wightbaby, you've been on Warfarin long enough now to have all those lovely little warfarin goodies trotting round inside you that you are protected.

Did you ever buy that Coaguchek device ?

John

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Thanks John........I have an alarm on my smartphone, because i am always "busy multi tasking" around 6pm! So with this reminder, I never forget to take my Warfarin......It just slipped my mind it was Tuesday......

I think this latest silly slip up, should spur me on to buy the Coagucheck ( its the price that puts me off!)......it would certainly stop me getting anxious!

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The last I heard, if it's of any help, is that Roche were doing an interest free purchase plan over 12 months. If this held anyr appeal it might pay to go into the Roche website and check it out.

John

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If you've only mssed 1mg, just take it the next day to make up for it. It really is unlikely to make a difference as you've only done this once. I invested in a coaguchek, and when I missed my daily does it didn't make much difference when I checked my inr. It will soon settle down again. If you are still really concerned just give your inr nurse a ring.

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Gmc54 thanks for your reply........if only I had the luxury of an INR nurse!! No such thing here on the Isle of Wight...be lucky if we still have a hospital soon!!

Its the general nurse at my surgery , that checks my INR's........and as nice as she is, I feel I know a bit more about Warfarin than she does (that is not meant to sound arrogant!). The odd time my INR's slip over 3...there is this big panic to alter my dose...but that is another story!

I have approached them re the self check thing.........and they really ARE against it, but I think I will ignore them and get one anyway

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Keep checking the coaguchek website, when I bought mine they had a special offer with a good discount. Your surgery should provide you with the testing strips, if they won't they can get quite expensive. I have never heard of anyone being refused the test strips by their surgery, unless another member here knows otherwise......maybe you could ask in another post if anyone has had a problem, it would give you a bit more 'clout' if we always get them free on the mainland.

It's far better to check your own and phone in the results to your nurse. I have to phone mine in every eight weeks to my nurse, but I also check for my own peace of mind about every two weeks or so. I get a pack of strips a year, they have a use by date on them, so they are only useable for about a year after collecting them from my surgery, so it makes sense to check every couple of weeks so they don't get wasted.

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I used to be on 5.5mg but could not be bothered to carry the 0.5mg tablet in my purse. So when I was out in the evening I routinely took only 5mg, which is a similar case to you.

While we are here. What do you do if you are not sure if you have taken your medicine? The universal advice I have seen is that, if not sure then do not take your pills. Balance of risk and probability. Missing one day is usually trivial. Doubling a dose is always more dangerous.

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Thanks for replying. It was only the 1mg that I think I missed, like you, everyone else on here seems to agree it shouldn't be a problem!

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I would just mention it at your next clinic. If it is a long way off phone them and see what they say, they may ask you to come in for a check. But I wouldn’t worry as you are on 5 mg. missing a dose of just 1 mg is not a big amount and you will make it up

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Next check due towards end of March.....and like you say 1mg is not much.

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Just have a glass of wine this evening... Cheers! :D

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What a good idea!! Red, of course : )

Cheers Eatsalottie!

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What a good idea!! Red, of course : )

Cheers Eatsalottie!

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Just contact your warfarin clinic. It’s easy enough !

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mycallc.....I don't HAVE a Warfarin Clinic OR a Warfarin nurse........life would be so much easier if we had these things on the Isle of Wight......!!! The GP surgery does not seems clued up at all.

To be honest, I feel more supported by folks on here...and they are more knowledgeable!!

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Wightbaby, I'm sorry to hear your predicament. I would most definitely not wish to be on warfarin without the close and regular monitoring of my INR which is of the utmost importance. How do you get your regular checks with no clinic or nurse ?

Yes, folks on here are great but they can't give your medical advice or attention, just their experiences.

I wish you well.

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Thank you for your interest and good wishes!

My INR checks are carried out at my GP's surgery, by who is, I assume, the "Practice Nurse"...she also does general blood tests, vaccinations, smears etc.....so not exactly specialised! I went in with a Vit K and foods info sheet once and she asked me if she could take a copy of it for the surgery as she had never seen anything like that before.

Sometimes the computer suggests my next appt should be in 8 weeks time. I am never happy with that (considering how INR's can change quite drastically in only 7 days!) and make sure I get one after about a month. The hospital does not have an INR clinic either.

The good news is......it's Tuesday today, and I WILL NOT forget to take my extra 1mg dose this evening : )

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Take your 1mg missed today or tomorrow. The coaguchek software at the surgery used to change the day of my extra 1mg depending on which day I had INR unless nurse changed it back manually so no harm done I'm sure.

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Ah....well...Bagrat, the dilemma IS......did I take the 1mg or didn't I??

Need an extra memory jog for the future I think!

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Just reduce your greens for a helping or so then maybe! I was never very strict anyway just sometimes thought oops no greens for a couple of days better have some. Talking in past tense as swapped to Apixaban a week ago.

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