INR question

Hi everyone. Im in the US and my lab tests never exactly state the ratio.my DRVVT is 27 (range 37-50). Anticardiolipin IgM 14.5 (range0-11). IgG 22.3 (0-23).factor VIII 66.8(50-200).INR .96(.86-1.18) . How do i figure if the inr is ok? The hemotologist was more concerned over the aps than the vonwillebrands. Im on aspirin and he wants me on xarelto. My last platelet test showed 427(143-394)hemoglobin14.4(11-15). Thank you...Teresa

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  • From what I understand of your blood results you are not on an anticoagulant like warfarin, just taking aspirin, therefore your INR will be the same as it is for the rest of the population which is bang on normal at around 1.0 Yours is .96 which is normal. You only have to worry about your INR when you start to use warfarin and you increase your INR to around 3 to 4 if you have APS because you are trying to keep the blood slightly thinner to stop it clotting (in simple terms).

    Xarelto which is Rivaroxaban has not yet been licensed for use with APS just with Atrial Fibrillation and orthopaedic use, its still undergoing trials. I do believe some Doctors have started to use it on some patients in the USA however off label. Xarelto has no reversing agent unlike warfarin which has Vit K if you bleed and this is why it is still in the trial stage at the moment.

  • Thank you APSnotFab. The hemo actually said that too that its a big deal to try and stop the bleeding because i have vonwillebrands type 2. So i asked why i should be on it and he said hes more afraid id have another stroke. Yet im afraid of it.

  • I agree with you. It seems so "new" over here. Im going to speak to my rheumatologist and my heart dr too. I have to say this community has been such a blessing to me, i have learned a lot...Teresa

  • Is there a reason he doesn't want to use warfarin?

  • Hi Salty...he cant use warfarin, coumadin or heparin because i hemorrhaged on plavix and had bleeding issues with 325mg of aspirin. But now the problem is the 85mg of aspirin im on has caused me terrible problems now with my joints and my teeth and gums. He feels the xarelto would be better for me. I dont have an md after my name but i read and im leery of it. Im afraid of bleeding on it

  • You need to make sure your Inr doesn't get too high or you will bleed internally. After passing a Pulmonary Embollism and spending 5 days in the hospital a week later I became very ill. i couldn't catch my breath even though I was on 4 liters of oxygen. My PT/INR was at 8 and I had Pericardio Infusion w/ tempenade.. They had to drain 1500cc of blood from the sack around my heart it took 2 days to do this. My kidneys shut down and I was in the hospital for 13 days trying to get my INR to be therapeutic . So you need to be very careful with it. It should sit between 2-3 so you don't clot.

  • The thing with INR levels is that it needs to be at a level that controls symptoms on the lowest possible dose of medication, that way you are less likely to have side effects. Everyone is different which is why giving a set level can sometimes be distracting because peoples reaction to medications and how their bodies cope with it is always different.

  • Hi, I am new to the blog and need your advice on the INR counting. I was diagnosed three years ago with APS. Since then I was taking a daily dose of 81 mg. of Aspirin. Recently as APS flared my rheumatologist add to treatment 1 daily dose of 75 mgr. of Plavix. Most of the symptoms I had been experiencing for the past many years (in particular headaches) have been relieved. I am suppose to be taking Plavix for six months but reading this blog I have realized that my doctor should have ordered periodical counts of INR which he did not. According to your experience, how frequently should I be tested? Thanks so much for your help.

  • There is no need to check your INR if you are not taking warfarin. Normal INR is around 1.00 which yours would be unless you start on anticoagulation with warfarin and then you would want to measure it regularly to keep it at around 3.0ish. So dont worry about your Doctor not ordering the counts.

  • Many thanks for your advice APsnotFab. I am learning so much from all of you guys! Keep posting on your experience. Unfortunately I don't have much help at hand in a small country as Venezuela where I guess there are no real specialists on APS.

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