INR levels and warfarin dosage

[Pepper56]

my mother in law has been taking warfarin since she had a DVT about 10 years ago. She had a INR test today and was told to increase her daily warfarin dosage from 2mg to 3mg. does anyone know what causes the fluctuations in the blood that determines the warfarin dose changes?

[Tipper]

What you eat is the main thing that changes your INR.

This is because some intake, like alcohol, makes the warfarin work better and some foods, like broccoli, make it work less, thus altering the INR achieved. I also find travel, change in the clocks, summer and winter time, and my stress level alters my INR and so the need to adjust my dosage accordingly.

I also think body mass affects how much you need to take to maintain your target INR. This has never been mentioned to me medically but I say this as I am 6'2" and, err, large, and take far more warfarin than my slim petite neighbour in order to maintain our respective INR targets!

[willowgirl]

hi, vitamins, other medications, toiletries, make up, health oils, food, alcohol, stress, weather etc etc etc, sorry cant help more but all these things alter mine, depending on how readings are i just have to think what ive had/used that is new, usually quite easy to pinpoint what it is and alter accordingly xx

[olddodds]

Hi

I endorse what TIPPER has said.In a nut shell, yes, any vegetables that i dark green, such as Broccoli, cabbage, sprouts, etc, are high in vitamin K. This will thicken your blood, {lowering your INR} Where as alcohol, garlic, onions, will thin your blood. Its also true that prescribed, & over the counter medications can rise or lower your INR.{ Simple medication, like pain killers} Its always best to ask your GP, or pharmacist, when being put on, or buying over the counter medication, what effect they will have on your INR. Then always inform your anticoagulant controllers what meds, you are on.I Would recommend all Warfarin ,& other anticoagulant & antiplatelet users to join ACE, & have a quarterly magazine called INREVIEW {costing £10.00} per year.There is a lot of useful information written. You can also down load a complete list of food, drugs etc, as to how it effects your INR. Your own well being will also have an effect on your INR, if your run down, cold /flu etc. Stress to will have an effect. So in a nut shell, have a well balanced diet, keep well & have some sort of excercise. Do not binge on high vitamin K products, or binge drink. Certainly avoid CRANBERRY, in any form, Yet i have had a small amount on my turkey at christmas, with no real effect. Self testing is the key {i do }.If you are unsure at any time due to a binge, or cold etc, you can quickly & easy check your INR. In any event do not panic.I could easily self dose, but i am happy to have my Anticoagulant team {NHS} as a safety net around me, daft as that may seem.But i find them always helpful. I am also lucky that my local GP, prescribes Self test strips & needles for me.

[gel1]

Hi PEPPER56

I have only been on Warfarin for 5 months and my INR has been erratic throughout this time, being in range only 50% of the time. I am not sure that body mass index correlates with achieving a therapeutic INR level, but more to do with your genetic make up and how you metabolise the Warfarin, as I have a BMI of 23 and take 12mg of Warfarin daily. I find the only way to keep stable is to have regular blood tests as when left for 4 weeks I am totally out of range. If I have to remain on Warfarin I will consider self testing and dosing, but wonder if I make this decision to go it on my own , does the NHS always provide backup, and provide parallel testing until you become established. I agree that the INR review magazine is very helpful and well worth joining. Along with this website and its contributory members a great source of useful information.

[mumknowsbest]

Hi I self test and self medicate, although I still have to ring the anti coag clinic every so often so that they keep my records up to date. They also check every 6 months to make sure that my machine is still callibrated with theirs

[nissanjean]

Diet, stress,infection,alcohol,medications etc.