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Warfarin

I've got quite a worry at present. I've one more days worth of my Warfarin left and am not able to get to the surgery to collect my repeat. Has anyone had experience of doing without? Does anybody know what could be the effect?

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Id go to emergency if you are worried I've missed a dose with no effect but had only been on it for a month

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Hi 7Helena. Sorry I accidently sent my reply to Cumbremar5. If it were me I'd really try to find some way to refill asap. Missing one day is something that most of us that have taken coumadin do once in a while as we are human and we can forget. But if not having your refill means you will be without for several days in a row you can run into problems with clots which can lead to a stroke.

Sorry to be so serious but this is nothing to play with. Please don't take a cavalier attitude about missing your anticoagulant doses. The consequences can be serious, long-lasting, and possibly irreversible.

Please take care of yourself. When you finally refill it's a good idea to plan ahead to refill well before you run out. This is not a medication to play with.

I took coumadin for several years for atrial fibrillation, did my own accucheks at home. I chose to have a procedure that meant I could stop them but when I was still on them I always planned to have some extra in case bad weather or some other situation came up suddenly to prevent my getting a refill on time. I was a nurse and there are some meds we can run out of without too many consequences. Coumadin is not one of them. Take care. irina1975

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Yes, I do have my Warfarin on a monthly prescription but although while I was still mobile I had 2 weeks to run. Unfortunately we are very isolated and without a vehicle of some sort can't go anywhere. I'm desperately trying to find someone who has transport and is available to collect the prescription for me. So far I haven't been able to find anybody but obviously still trying. My surgery won't put them in the post. Thank you for your advice.

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I'm sorry you are having such trouble; I did have a thought. If your last INR was within range and not done too long ago until you can get meds and back on track I would suggest avoiding the foods that can lower your INR. You know, leafy greens, salads etc. Not a great solution but something I would try just in case it keeps your INR from drifting down too fast. Take care. irina

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PS garlic, onions, and cinnamon are foods that can raise INR's. When I was srill taking anticoagulants (Coumadin), I managed my own INR's and dosage changes. I learned to do a lot with 'raising and lowering' foods.

Maybe worth a try! ie oatmeal with cinnamon! Sounds dumb but it worked.

Take care. irina

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Thank you for that. I'll certainly try oatmeal.

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Sometimes simple things work. I checked my INR weekly and the doctor helped with this plan. Instead of raising or lowering dose if it was slightly out of line I would try to adjust it with diet the following week. This worked well for me. Sometimes if it was too high I had brussels sprouts and broccoli for breakfast and left my dose alone. Crazy but we do what we have to do. Dump a lot of cinnamon on that oatmeal-or bake an apple.

A word about cinnamon. There are two types. One is known as 'true' 'cinnamon and is usually labelled Ceylon cinnamon. The other is a bark similar in taste and appearance to cinnamon called Cassia. Cassia which is cheaper is usually what is sold in the grocery store . True will be labelled "Ceylon".The Ceylon (true) cinnamon has a higher amount of curcumin than the Cassia. Curcumin is the ingredient that causes the cinnamon to affect INR's if you eat too much.

Feel free to use what you have on hand. I've used both.

This is probably more than you ever wanted to know about cinnamon. Anticoagulants are a big pain. I chose coumadin so I could control my levels better.

But finally got tired of it all and had a LefrtAtrial Appendage occlusion in January. Weaned off and had my last anti pill July 29th with a glass of champagne!

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7Helena Correction:: I just checked my facts about cinnamon and I said it backwatds: Cassia is higher in curcumin. True/Ceylon cinnamon islower. Very sorry. Something told me to check.

It's 5 here in Atlanta. Think I'll have a glass of wine. Take care. irina

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I am more and more confined to my house but have sorted my repeat medications and through an app called Now Patient they are delivered by post or if they are too big for the post box they now deliver by courier with an arranged 1hr time slot. I have now got peace of mind as I have had times through the winter due to no gritting on our bank where I live and no one to collect for me this is a god send.

Good luck

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Don't worry, nothing drastic will happen in the short time it will take to get yourself sorted. Can you ring your surgery, explain the situation, ask them to do an electronic transfer of your script to a pharmacy you normally use? Then ring the pharmacy if you can't get there either, explain it all again and ask for a delivery. Or if you are known at the pharmacy they are usually willing to "loan" you a few pills ahead of them getting your prescription. I know all these methods work, I've got a shocking memory! In the future, register with your pharmacy to ring for repeats or use Emis, patient access, you have to register for this at your surgery. Take care.

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Thank you for excellent advice but I'm without transport and am unable to walk to the public road which I'd normally do for a lift. The surgery is now aware and I've suggested that they post them but they don't normally do this. I'm hoping for a reply soon. I am on a repeat prescription. It's a relief that it won't have an adverse effect.

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The pharmacy is in surgery who won't post. I have now made a suggestion that they forward a prescription to Boots who do have a postal serve. Thank you for that advice I hadn't thought of that before. I know it sounds wimpish but it just hadn't crossed my mind.

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Asking the pharmacy to 'loan' you a few is a great idea. I've done this in my time. They even allowed me to pay for the 'loaners' when I picked up the rest of the Rx. It is not a controlled substance and pharmacists know how important not missing coumadin doses can be.

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If you ring your usual pharmacy and explain your situation, I would hope they would bring your warfarin to your home. I would not knowingly miss even a single dose of warfarin unless I knew my INR was within range.

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They can't reach my home because they are afraid of damaging their cars on our farm roadway.

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DO NOT WORRY - I have often missed a day here and there BUT more importantly, I have twice had to stop it altogether for ... 1) a CT Scan and 2) for knee replacement surgery. No problems. On these occasions I was off it for 6 days. It will take that long for your INR to drop to a normal persons INR value.

When you get your next supply DO NOT be tempted to play catch-up! Just carry on with your normal dose unless otherwise directed by a medical professional.

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I know it's hard to ask for help. We are all bad at it but is there a neighbour or friend that could pick up a repeat. It gives someone the chance to feel good about helping another person too. Many people have to stop for a few days for procedures and all is well so dont worry too much. How do you get to have your INR checked?

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Thank you Bagrat. I'm trying to find somebody near who can help. I know it can be difficult to imagine but we live in a very isolated spot with no more than 3 neighbours all at some distance away. I have asked them who will collect them if and when they pass by the surgery. They are all at a different surgery in another town. Tonight I've emailed my pharmacy as suggested by Joynjoy.

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Ring your surgery and ask for the repeat to be sent urgently to a pharmacy that delivers

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We’ve all missed the odd dose, I know I certainly have. If you have a smart phone set an alarm as a reminder daily, and carry your warfarin with you. Since doing this I have never missed. You can also set a reminder to ask for tour repeats each month.

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Hi Helena

My prescription is always sent electronically straight to my pharmacy, who then deliver the prescribed items to my house. Doesn't your pharmacy offer deliveries? Have you asked them?

Sorry you've had this worry. What area of the country do you live in? If you live anywhere near me in the Torbay area of Devon, I will gladly collect and deliver your pills.

Jean

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Thank you. I live in rural Shropshire. Tonight I've emailed the pharmacy asking them to forward a prescription to my nearest Boots who I know do a postal service as suggested by joynjoy.

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I would phone surgery and explain situation, ask them to fax or send to pharmacy asap, and also contact pharmacy and see if they will issue as an emergency explaining prescription to follow. Pharmacies will often issue in an emergency, if you are a regular customer

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Although the effects of a stroke are a big concern, the actual risk of you having a stroke due to missing out your medication for a few days are very low indeed. We people with AF have a five times greater risk of stroke than the general population, but even that comes out at a quite low risk. It makes sense to avoid that risk if you can, but don't let it prey on your mind, just fix it as soon as you are able.

If you would like to see a sensible presentation of the risk, try the YouTube video that Sanjay Gupta has done here:

Good luck.

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As an eternal optimist, I consider that my stroke risk is less than the average as I'm anti-coagulated.

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You'll be fine but make sure you order your next supply well before this latest lot run out. I try to keep a reserve of around 10 days supply !

If you go away on holiday you need to be sure you'll have sufficient for the duration and some spare for your return home.

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Thank you very much all of you. You're marvellous! I've now arranged for the Warfarin to be sent to me by post.

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