Warfarin and INR Levels

[Knavesmire27]

Hi allHave been on Warfarin for about 4 months now and still having lots of fluctuations with my INR and warfarin dosages. My reading has dropped the last two times I have been - and the last one went slightly below range - it was 2.4 (target is 2.5-3.5). So have to go back this week. I am doing ok with my diet and I exercise every day but I do think part of the problem is the constant changes to other medications. For example my Ramipril was increased to 10 mg a day and have stopped Metformin altogether. I have also been put on Amlopidine 5 mg a day. So I had to take a boost of 8 mg one day and for the rest of the time have gone from 1 x 7 mg dose and 6 x 6 mg doses a week to 2 x 7 mg doses and 5 x 6 mg doses a week.

I know these are not massive increases but I still do worry that doing this could push me too far the other way (above target). For example the other day I got a bruise on the inside crease of my thumb where I had been holding tightly on to a metal handrail while going up a hill 🙄. I took 7 mg last night and I will take my second 7 mg dose tonight and then on to the 6 mg until Wednesday when I will get tested again. Is it ok to go over? Is it better for it to be over rather than under? Any advice would be greatly received.

Thanks

[nossib]

Hi Knavesmire27 , I also often have fluctuations in my INR levels and although sometimes no real explaination,I agree about the changes in medications [ also taken off metformin, now taking trulicity once a weekly and in my case, frequent antibiotic for kidney infections [ have had several trips/ surgeries for kidney stents and stone] currently, my last two INR readings have been low [ 1.8] and requiring checking twice a week. Strangely, they should have gone higher from the antibiotic I'm on but instead , have gone too low.

My target should be 2.5 . If your INR goes too high, there are risks of bleeds, if too low, increases risk of clots. Good luck for your next reading. Susan.