Question about INR

[Tonkawoman69]

Hi, I have just had my first INR test before going on Warfrin. I started my first one tonight . My starting point was 1 would I expect my INR to go up on warfrin? I have only been diagnosed with Lupus and Hughes this week coz of blood clot in arm and now damage arteries in hand. Thanks Andrea x

[laserlight]

Hi Andrea

Welcome! It will go up but it will take a few days and then some to stabalise. Warfarin takes about 36 hours to make a difference to your INR. What's your target range, eg 2-3, 3-4 and so on? How many milligrams (mg) is your first dose and what instructions have you been given for after that? Check the Hughes website; there's a lot of useful info on there:

Hughes-syndrome.org

Post again on here and you'll find loads of friendly guidance. It can be puzzling when you first start but those of us who've been where you are now will help!

Best wishes, John.

[Tonkawoman69 in reply to laserlight]

Thank you john. My INR is 1 my nurse never said what I'm expected to go up to? Should she have said? Or will she tell me on 2nd blood test? I took 10mg yesterday that was my first day , have to take 5mg tonight and 5mg till blood test. I take it they might put it up? Do my children need to be tested for Hughes ?

Andrea x

[laserlight in reply to Tonkawoman69]

Hi Andrea

Manofmendip explains things very well below. Your loading dose is 10mg then, to 'kick-start' things, followed by 5mg until your next test. When is your next test? It shouldn't really be any longer than a week after your first test, max.

Your nurse will be working to instructions from your haematology consultant or doctor. They'll have set your INR target range, probably 3-4 or 3-4.5 and the idea is to aim for the centre of the range and stay consistently within this range. They may change your warfarin dose up or down depending on your INR (International Normalized Ratio) shown by each test. Ask your nurse what your target range is. Don't worry if it wanders around your range or hits the top or bottom. It's ten times better to be slightly over range than under. Source: 'Sticky Blood Explained' by Kay Thackray, an extremely good book to start you off, if you wish. You can get it from the Hughes website:

Hughes-syndrome.org

At our recent annual Patients Day on 15/05/13, I asked Prof Hughes your exact kids question. He said yes, definitely have them tested. TWO tests are required. Ask your GP for 'aCL' (anti-cardiolipin) and 'LA' (the confusingly named, Lupus Anticoagulant).

I hope I've been concise and lucid. Anything else, just ask! Remember; there's no such thing as a stupid question, the stupid thing is not to ask.

The very best treatment to you,

John X

[MaryF Administrator in reply to Tonkawoman69]

I notice you were asking about diet on the Lupus forum, APSnotFab has re loaded this a few time, and you will find it useful: If you read under this thread: hughes-syndrome.healthunloc...

Mary F x

[Manofmendip]

Hello Andrea

Welcome to our forum.

The starting point of 1 is what most people would be, before starting on Warfarin.

You will probably be taking a realatively high, 'loading' dose of Warfarin to get your INR moving up and then the dose will probably be reduced, after a few days, to try to round out at your target range.

Many APS patients need to be at an INR around 3.5 to 4.0 in order to start to feel better and sometimes it is difficult to persuade INR clinics to take you to that figure; they are more used to people being on Warfarin for other conditions and needing an INR o 2.5 ish.

Good luck and keep posting.

Best wishes.

Dave xx

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I was put on 18mg and now I am back on my 9mg, which is my usual dose, is 9mg too high for the average range/ everyday dose? my bloods are still relatively low but I have been back on my Warfarin for over a month now. I am so glad you say it is better to be higher than lower. My bloods were 2.3 last week and I still feel unwell. that is still low for me. Why do some people have an INR at different extremes?

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Hi jumpingpeggy,

Look at what Dave is Writing above!

The INR is important not how many mg of Warfarin you eat .Constancy is important. The more you eat the same food the easier it is to keep in range. Also if you eat vegetables rich in K-vitamin. Eating lots of K-vitamin rich vegetables lower INR. It is good to eat vegetables rich in K-vitamin. It is good for the coagulation and the blood for us.

If you eat K-vitamin vegetables you are likely to raise your intake of Warfarin but that does not matter. It is better to eat vegetables rich in K-vitamin and a higher mg of warfarin than just a little vegetables rich in K-vitamin and less tablets of warfarin

Some people does not understand how to manage warfarin. When you manage it warfarin is a very good medicin. Especially for us with APS.

But....... we are all different!

Kerstin

[Tonkawoman69]

Thanks Kirstin. Im trying to teach my doctors about what I have as there is not much knowledge and they dont seem to be that clued up in my area. Got to see a specialist but that taking ages. My OH consultant was very helpful today he said get into |St Thomas London it will get back on track then can manage the illness better. I think if things dont improve I m gonna have to find money to see a specialist privatly. Cant afford it coz of on half pay and loss of SSp applying for other support but not banking on it with this government.

Thank you Andrea x