INR High - feeling fed up!

[Wightbaby]

Recently had a Urinary Tract Infection, and prescribed 2 courses of Nitrofurantoin (anti-biotics) to clear it. There are still blood traces in my urine, so got to have an endoscopy next week.......my INR's were 3.9 this morning (at the surgery). Endoscopy dept said they will only do it, if i can get them down to less than 3 by next Monday!!

Wondered if the AB's caused this soar, or the infection itself? Or even the blood traces?

Any thoughts anyone? Any else any experience of this?

may not be able to check in on here until Friday.

[BobD Volunteer]

Antibiotics can cause this which is why extra INR testing is advised if you take a course of antibiotics. If you stop now and re test Friday you will likely be back in range as it take a few days to drop.

[10gingercats]

Thinking of you. Hope you sort this soon.

[Wightbaby in reply to 10gingercats]

Thanks June. Are you still coming to the island soon?

[Hidden]

Start on the brocolli/ spinach now to help you along !

[rosyG]

spinach brought mine down within hours but you mustn't go too low or will be at risk

[Hidden]

I would say it might be the infection. Nitrofurantoin and warfarin are not reported by NICE BNF to interact, so presumably it isn’t common. Is your INR normally in range? Maybe it was partly because the INR has been a little out of range for a while.

When I was on warfarin, if my INR was high but under 4, I simply missed one dose and retested the next day. If I was back in range, I restarted at a slightly smaller dose. There are several advice sheets available online for managing raised INR. But then I never bled on warfarin. The advice is different if you are bleeding.

[Wightbaby in reply to Hidden]

It really must only be small traces as you can't see them...my urine looks really healthy colour etc......sorry to be basic!! : 0

[Dodie117 in reply to Wightbaby]

Kardia is not difficult to set up. Just need to get used to getting the drop of blood in the right place. You may waste a few strips at first but you would get used to it. Maybe GP or friend could help.

Have you considered DOAC?

I changed and is a lot less hassle. I had no particular problem with warfarin just inconvenient for me.

[MarkS]

If you had a Coaguchek it wouldn't be a problem. I know you said the local surgery didn't dispense the testing strips, but may be change to the one that does (or create merry hell with your practice until they do). Otherwise just buy them on the internet, £3-£4 each seems like a small price to pay for peace of mind.

[Wightbaby in reply to MarkS]

I agree...its the support to get started that I need....you know, set it all up.....I would be happy to pay for strips, even if £5 each!

[MarkS in reply to Wightbaby]

I've helped a number of people get started using Coagucheks including neighbours and their relatives. So if you're ever over in the Portsmouth direction, I could help you get started.

[Wightbaby in reply to MarkS]

Thanks for the offer...its a bit of a trek...but I may consider it!

[Jollies]

A couple of winters ago I suffered from recurrent chest infections and had a load of antibiotics. Played havoc with my INR readings. Due to this and frequent visits to the doctor I made the change to NOACS

[Wightbaby in reply to Jollies]

Hi Jollies

Please could you tell me if you had to have a gap in meds when you changed?

That's what puts me off...I don't like the idea of 'not being protected' even for a short time.

Although my 91 year old mum in law was told she could start on Xarelto, the following evening after she had taken Warfarin.

PS...she didn't like it...said it made her itch!!!

[Hidden in reply to Wightbaby]

Hi Wightbaby

When I switched from warfarin to apixaban, I stopped the warfarin, tested my INR daily and started the apixaban when the INR was below 2 as below. Apixaban works quickly so anticoagulant cover was continuous.

gwh.nhs.uk/media/236485/doa...

[Wightbaby in reply to Hidden]

Thanks oyster

[Wightbaby]

On Friday, they were down to 2.8....this is coz the computer changed my dosage to 3's or 4's per day rather than 5mg......this is actually a very low dose, as i have not taken less than 5mg per day since 2013! And in all that time I have only been out of range about 6 times and 2 of those were this year!

Anyway the endoscopy can go ahead tomorrow, and once that's out of the way,(depending what they find) I will probably revert to my normal dose, or I will drop right out the other end of the range!! A drop of 1.1 in only 4 days is quite a big one in my mind!!

[10gingercats]

I changed from Warfarin to Apixaban 2/3years ago and it was no problem.First of all I had to see my GP........we had had numerous chats as to the best NOAC for me.... and then get the script.for Apixaban and then reduce my Warfarin down to I believe it was.1 then start the the Apixaban. It took two nurse visits to check I was down to 1 .I then started to take Apixaban..... 90% sure my memory serves me right as I have written. But it is probably fairly standard how it all proceeds. You will have confirmation here as to to whether I am spot on or spot off!. Either way it was easy enough not to worry me.