Warfarin dose

[Itiswhatitis]

Hi, just out of curiosity, I was wondering what kind of warfarin dose people are on. At the moment I'm on 11mg weekdays and 12mg at weekends. Range is 2.5 to 3.5 and only just got my INR into range again after about 6 weeks, before that i was on 10mgs a day. Is this considered a high dose or normal for APS?

[Lind8]

Hi I started off on 5mg a day many years ago & now require 23mg daily to keep Inr 3.5 to 4. Consultant said that over time I have built up a tolerance to Warfarin & are not overly concerned about the high dose except if need procedures. Hope your INR stabilises again soon

[Itiswhatitis in reply to Lind8]

Thank you, makes my dose not so bad then.

[steamrlr]

5/4/5/4/5/4/5mg Sun-Sat range 3.0-3.5

Weekly home monitoring.

Good luck!

[David-Nisbet]

Was on 9/10mg for a long time. Range 2-3.5. Now on 11, 11, 12. Taking a while to settle again.

[Sand1985]

8-9mg daily range 3-4. Started warfarin / aps diagnosis in sept 2022

[Fra22-57]

on 6 and 7’s at moment but have been upto 10.my range is 3-4

[Moorey2]

7.5mg Monday to Saturday 8.5mg Sunday currently 1.9INR (2-3)

[Yodel]

Hi there. I sympathise with you regarding getting your INR in range. My INR is unstable and I often need to have it checked weekly. I have been on warfarin for 20 years. Currently I am on 4.5mgs 4 days a week and 5mgs 3 days a week. For a couple of months earlier this year I was on a very low dose of 3.5mgs daily. My highest daily dose has been 6mgs daily. It seems that we are all different!

[GinaD]

Effective dosage depends on patient's weight, activities and diet. As well as the target INR. I too remain most stable on a varied doseage, as well as eating 2-3 servings of those green leafies daily. One doctor ( since retired) explained that varied doseage plus eating vitamin K foods makes it less likely that the body will not build a tolerance to warfarin. I remain symptom free with an INR as low as 1.7 and I take 7 mgs 5x a week, 8mgs 2x a week.

[cjwinthesun20]

I’ve been taking for 17 years with a range 2.5-3.5. Like others my readings are variable but generally I take 5mg a day. I’ve never worried about drinking alcohol and although certainly not alcoholic I do drink a few beers or glasses of wine most days. At times this can push readings to 4-5 but it’s not a big issue to get back in range. Just take less warfarin rather than less wine.

[Suejane]

Hi,My range is 3-4. I've been on 12mg in the past, and need more when I'm fitter. I don't know if it's considered a high dose though.

[MackinLake]

Hi, I've been on warfarin 2 years 2-3 range .I take 5-2mg,2-3mg but I am good for 1-2 months then usually drop. I guess your dosage sounds normal . I didn't know that you could take more than 5mg at a time .Good t to know. Ty

[Bagpuss01]

This is considered a high dose, I was on 14mg daily for a long time and my own Doctor queried it.

[Patientlyoptimistic]

I’m on 18/19mg daily

[KateEsq]

Dosing is very individualized to you - your body and your diet. I took a long time to get into therapeutic range. My usual dose for years was around 20-25mg a day. It shocked and scared all my providers. I go to a clinic that has a lot residents (trainee doctors), and they were very hesitant to prescribe me such high doses. Eventually, after rounding me through several doctors, I finally ended up with one of the senior teaching doctors who follows my INR. I am now infamous in the clinic for being "oh, you're that one" whenever someone else has to follow up on my INR. Then I naturally had to go and make things more confusing for all of them by learning about vein draw testing INR, checking it out, and discovering I'm one of the lucky ones that has to do INR by vein draw.

The highest regular dose I've been on is 35mg a day and that was for almost a year before it started ranging between 25-30, then 20-25 a day.

Recently this year, my dose decreased to 15mg a day, which is the lowest I've been on since I first started warfarin in 2015. It was rare for me to drop below 20mg. It's likely a decline in natural stores of vitamin K or something else. Though, at my latest draw my INR was 1.8, so my dose may be going up again.

My therapeutic range was 2.0 to 3.0 post DVT/PE. My hematologist bumped it up to a preferred range of 2.5 to 3.0 because my clotting was so extensive. When it was discovered I had APS it was raised to 2.5 to 3.5. When I had a spontaneous spleen bleed in 2018, my range was lowered to 2.0 to 3.0.

But, as you can see, the dose doesn't really equate to range. It's more about what's going on in your body. Some people are more sensitive to warfarin than others and need very little warfarin to get into range. Me? I usually need a lot. I know I'm an outlier because my Walmart pharmacy had to special order 10mg warfarin and had trouble keeping it in stock because they just didn't see that dose normally.

Keep in mind, your body functions, your health overall, your diet, and your medications all interact and affect how warfarin is metabolized. It's more important to be in therapeutic range than to be concerned about the size of your dose. The size of your dose is concerning when it comes to going on or off warfarin, if your INR is becoming more variable, or if there's a big change. This is not necessarily because of the size of your dose but because it may indicate that you need to look at your whole health and figure out what has changed, like diet, medications, or health.

[KellyInTexas Administrator in reply to KateEsq]

you may have a gene mutation of VKORC 1

I did, it means you metabolise warfarin poorly. ( it might take a bit more for you.)

I weigh 112-115 , when I was on warfarin my INR was kept very high and I was taking about 18 mg a day.

pubmed.ncbi.nlm.nih.gov/147...

[Itiswhatitis in reply to KellyInTexas]

Thank you that I will have a read of it.