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Maximum INR levels according to country patient resides in

henyrjonze profile image
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I've been reading today's posts about INR levels. I live in the US, where the medical community sets a "healthy" maximum INR for APS at 3.5. I feel best between 3.0 and 3.5.

But I've been reading about people's INRs going up to 13.4 (not good!). Some people seem to set an INR goal of 4.0. I am wondering what some healthy maximums are in other countries.

I'd be interested in hearing your responses.

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henyrjonze profile image
henyrjonze
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KellyInTexas profile image
KellyInTexasAdministrator

pubmed.ncbi.nlm.nih.gov/310...

Sher78 profile image
Sher78

I think maybe it all depends on your medical history, whether you have had strokes, clots etc. I am in the UK and my hemo likes mine between 3.5 & 4. I have had a previous stroke & several clots over the years.

KellyInTexas profile image
KellyInTexasAdministrator

henyrjonze,

The best practice for setting the INR are “recommended guidelines” and they are international. The US equivalent of EULAR ( European League Against Rheumatism) is the American College of Rheumatology. They follow the same recommended guidelines.

Every now and again a patient’s body hasn’t read the recommended guidelines. This doesn’t happen often, thankfully.

The patient is a “super clotter” and continues to form DVT’s in veins and or arteries despite multiple trials of LMWH’s with a recommended anti platelet like clopidogrel ( less bleed risk than aspirin.)

These patients ( like me) may need to run a higher INR, and be put on immune suppression.

Lure2 profile image
Lure2

I only know of Warfarin (which I use here in Sweden since 2012. I also selftest) which is said to be the best drug for APS if we tolerate it as most do I think.

What therapeutic INR- number we need is individual and depending on several things like severe typical symptoms and also how many antibodies the person is diagnosed with and how high titres. You can feel when you are too low in INR as then the symptoms return, at least most of us can feel it.

When you have this illness and take Warfarin it is important fo follow the INR closely.

When the INR is too high (also individual but up to 6 or 7 which is too high for me) there is a risk of bleeding. Prof Hughes has said "that we do not bleed from APS but clot a lot"which is very true but an INR of 13.0 may be dangerous. It may also depend on what age the patient has. Elder people tend to bleed easier.

Also it the Doctor who is in charge of the patient who should decide about the INR and also see to it that the patient will follow it.

Lure2 profile image
Lure2

I take LMW Heparin in a shot when the INR is under un INR of 3.5.

MaryF profile image
MaryFAdministrator

So important the prescribing clinician regarding of country understands the individual needs of a patient with Hughes Syndrome/APS. MaryF

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