Just started warfarin

I've been on warfarin for 2 weeks 3 days and have a target INR of 3 following instructions from Professor Khamashta. I've had three blood tests, the first was 1, the second 1.1 and the third today was still 1.1. The GP started me on 2mg warfarin then increased to 3mg , then 4mg and today advised alternating daily between 5 and 6mg. I realise everyone responds at different rates but can anyone tell me roughly how long it would take to reach my target INR. My GP is very sceptical about my typical APS symptoms and implied today that they are all in my head.


10 Replies

  • Hello, I started warfarin 2 weeks ago with a target INR of 3-4. I take 4mg a day and am only at 1.6 and now increased to 5mg a day. My nurse said that it will take around 3-5 weeks to get me in range. But am on clexane injections until I am.

    I'll be interested to hear how long it takes others. My consultant who is an APS specialist said that aps patients can be quite resilient to warfarin so would expect it to take a little longer than normal.

    Hope you get in range soon :)

  • Thank you for that 'Tinythepanda', it's good to hear from others in similar circumstances, puts the mind at ease, especially as two GPs at my surgery don't have much APS knowledge and seem a little reluctant to learn. Eight months ago I offered one some Hughes foundation information sheets which he flatly refused! He is still just as uneducated, makes me cross. Glad you have an understanding doctor, sounds like it's just a matter of waiting. Hope you feel better soon xx

  • If your GP is reluctant participant I would simply ask to be referred to your nearest anticoagulant clinic at the local Hospital and ask for the letter from the GP that Prof Khamashta wrote with his instructions. It is your right to ask for a referral and if he refuses I would change GP's or ask to see another in the practise or ask to see the Practise Manager. This condition is for life and as hard as it is to hear this you need to find Dr's that you are comfortable with and who are willing to work with you or you will become very frustrated and miserable. There are good GP's out there and if yours isn't one of them then please find another who will. You will be so happy that you did.

    Good Luck.

  • Thank you for that advice, I'm on GP number two at my clinic already and although he started out sounding like he understood and was going to be helpful, he was the one who suggested that I had talked myself into my symptoms (grrr!!).

  • Oh dear well try another but if you feel its a generalised practise view you may have to look for somewhere else.

  • INR is a fickle thing and many of us find that it is often out of range. Mine was nice and steady for several weeks and then suddenly dropped for no particular reason. I eat the same thing day in and day out so it was nothing in my diet. I find I'm chasing shadows with it most of the time. Its probably better to aim for a range ...say 3.0 to 3.5 rather than a single figure like 3.0

    Various foods, medications, vitamins, alcohol, exercise and illness will affect INR

  • When starting on Warfarin most people are on Clexane until their blood is in range.

    If your professor says you need a higher INR who is your Gp to argue with that. Perhaps you could phone your consultants secretary and ask her if she could ask your the consultant to speak to your Gp.

  • They started me up on 3 tablets (7,5 mg) The same evening I did see everything more "clear". Two days later I had 1.4. Many of my symptoms came back as I only had warfarin now.

    Now I took 2 tablets. 6 days from the start I had 2.0. 13 days from the start I had an INR of 2.5. I took 2 tablets. 17 days after the start I had 3.1. I took 2 tablets.

    The first months my INR went up and down and they changed the tablets and i was down to 2.2 some days. My Hematologist decided the doses.

    Today I selftest and the warfarin has become my "Life-saver".

    This is me and we are all DIFFERENT!!

    Today (2 1/2 year later) I take 2 tablets also but I eat K-vit vegetables every day.

    Best wishes from Kerstin in Stockholm

  • It could take a few weeks of tweeking your VKA to reach your goal INR. Try and keep your drinking and dietary habits consistent as Warfarin is a fickle beast to manage, especially in the early weeks of therapy. Good luck

  • Took me at least 3 months of the initial 6 month course to stabilise, always low and was a dart board from Heparin injections alongside, on restart of life long course after month off to 'clean' for tests was a little easier as we sort of knew roughly where the dose was, but still took a good few weeks to settle. For first year it was 10mg that stabilised back to 8, this year I had some freaking all over the place moments and I am now on 7 to get my target of 2.5.

    We are ALL very different with differing diets, lifestyles and metabolisms and this is what actually dictates how much of any anticoagulant you need.

    And then it changes.. often.

    It is easier and I guess safer to slowly work the count up rather than have it shoot too high especially as one person on 2.5mg could have the same INR count as someone on 10mg, there is no hard fast formula.

    I think that for us 'Newbies' there is this fear (especially for those that have clotted or worse) that if we aren't 'bang on' the INR we will suffer rather than the experienced who know it mucks about and to just roll with it, adjust and keep checking. People don't tell you this as they probably just don't know, that's why places like this are so good, I have read more and settled my worries more on here than by anything else just because you suddenly realise... its normal.

    I think it is becoming clear to me with time that this target range rather than exact number is what is more important to aim for. I am at the stage of discovering what the best range is I think.

    On the sceptical GP front we either have the same one or they went to Doctor School together!

    Good luck with settling the count down, it takes time, your body is acclimatising, it will shuffle about, don't worry, just keep adjusted

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