My pt/inr 1.9 was under my target goal of 2 to 3 this am. I didn't get a response from my clinic so I took my 2.5 earlier than usual around noon. I forgot and took another 2.5 at 10:30 tonight....
I'm worried because i'm an afib patient and also have thrombocytopenia.(low platelets) I worry about the possibility of a bleed.
I self monitor so I will check before i call them in the am...I'm pretty sure it takes 2 or 3 days for anything to change. Any advice will be appreciated.
Speak to your INR clinic and get advice, at least you can self monitor. If morning is the time of day you normally take your Warfarin then if you have enough test strips on hand test it then or just before you phone and see what the actual reading is and don't panic.
From my own experience of 12 years and about 11 and half of them self testing I think you'll be surprised at how slowly that extra 2.5 takes to get through the system. If you have problems with your INR clinic I would suggest take your next morning dose when its due your next morning dose.
Are you normally within range ( 2.0 to 3.0)? Is your target INR 2.5 ?
When I have had surgery and had to stop INR it has taken me 6 days for my INR to drop to normal, i.e. 1.0 ! It has then taken me another 20 days to get back up to within range.
If this is your only ever crime with Warfarin then don't worry.
From my experience if you were at 1.9 and you've double dosed you are unlikely to get to 3.0 or above. I've even gone to 3.5 in the past. If you get even up to 5.0 so long as you get advice from your clinic its unlikely to be an issue except your blood becomes 'thinner' and so the risk of a bleed increases.
Let us know how you get on.
John
Skip your next 2.5 and you will be back to normal, overall. Take a 1.0 to compensate for the time difference, and that you are trying to get your INR back to 2.5
I take 3.5mg daily to keep myself on, or around, 2.5. If my INR goes to 2.0, or 3.0, I adjust the dose by 0.5mg for two days to get myself back on track. Anything more drastic, and it overshoots the other way.
Though your experience may differ, or course.
My INR went up to 8. I almost bled to death through my stomach.
Wow. How much too much Warfarin did you take over what period of time?
I was taking the med without getting my INR monitored. No one informed me. Doctors were closed from dec. 20 to Jan 4. I couldn't get an appointment. But I had no clue what the repercussions were, I had no clue how dangerous it was. I checked out of the hospital and was told by the oncologist I need to see her at least once a week. I was living on ignorance because I should have looked up the drug and read about it, but at the time I was so sick, very sick, it was all I could do to get out of bed to go to the bathroom.
I don’t think that it is sensible to skip a dose when the INR was low anyway. Speak to your anticoag clinic d as no ‘maybe’ ask about increasing your 2.5 to 3 mg 2 or 3 days a week as better to run higher than lower. Bottom line, double dose is not a concern esp
If your inr was low. Don’t worry. But please speak to your clinic before you miss any doses
Hi Suebo2
I would hesitate to argue with a Moderator (🙂) but can I please set out my thinking here?
Warfarin is a very high hysteresis thing; it takes effect slowly, and it loses its effect slowly.
So while koko528 was at INR 1.9, they had taken 5 mg of Warfarin before posting, the effect of which would be to make their INR ramp up over the next two days, and my judgement was that if they took another 2.5mg at the next dosage point, their INR would badly overshoot.
And I didn’t suggest they miss that dose; I suggested they should take 1mg because that is about the amount they would be down from having had what in effect was ‘this dose’ a day earlier.
I’ve had a couple of practices tell me that Warfarin is very capricious, which is true, as ‘Warfarin hates change’; but in a stable situation, any unpredictability as to what a dose of Warfarin will do is purely down to not looking at the recent dosage history.
Believe me, I monitor this stuff as if my life depended on it; because of course it does.
Dear MV, there is no problem with ‘arguing’ with a moderator - believe me, so please don’t worry.
It is difficult and everyone is different and often react in different ways. I think that it is risky for anyone on here to give advice but we should be advising members to ring their warfarin clinic for advice. I misread your post as you had mentioned ‘skip’ The issue here for me is that missing doses can really affect the INR and as the INR was low in the first place , taking a double dose would not matter (in the same way, as clinicians often ‘boost’ patients who may have missed a dose as they have unusually low INRs and are very stable.
Without knowing all the recent doses taken and the stability of the INR it’s hard. In reality, if the INR goes a wee bit high in a couple of days it will not matter ( unless the patient has a high bleeding risk) but having a low INR is more risky.
It’s good to debate and never worry about questioning anyone, none of us are perfect.
Have a good day.
Get yourself a medicine tray. I take my warfarin at night before bed. If you are working , mornings can be stressful. rushing out for the bus.
My INR was an 8!! I almost bled to death internally.
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