What is Pulmonary Embolism
By far the most common form of pulmonary embolism is a thromboembolism, which occurs when a blood clot, generally a venous thrombus, becomes dislodged from its site of formation an...
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High INR
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I see Loveheart posted about low INR and that got me thinking about what happens (or what should happen to be more precise) when you have an INR that is too high.
My INRs have been pretty consistent between 2 and 3 for the last month but then last week I spiked a 6.5. The first doctor who I saw at the clinic after the test said not to take any warfarin for 2 days and then retest. When I went back for the retest the second doctor asked why I didn't go to the hospital. I said I wasn't advised that I should just to stop taking the warfarin for 2 days and come back. I asked if I should have gone to the hospital and the second doctor said yes to receive treatment. Like most things surrounding DVT and PE the recommendations probably vary from doctor to doctor and country to country but are there any general guidelines on this? Are there different levels of high INR? When do you need to receive active treatment to reduce the INR and when can you just stop taking the warfarin and let the INR reduce more slowly back to therapeutic levels? Posted on 06/26/09, 05:06 am |
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Hi Mecab,
My INR target is now 2.5-3.5 because they are not sure whether I had new clots when I was hanging around the 1.9-2.1 range. The original target was 2.0-3.0 but the DVT nurse was not too concerned about me being so low. To counteract this the hospital upped my target and today I tested at 2.8 which is perfectly within both ranges :-) Hope that makes sense? 
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2.5 to 3.5 is common. My InRatio meter has, as one of its features, alerts for tests outside of target. Two preselected target ranges are 2.0-3.0 and 2.5-3.5, and it is customizable to any values detectable by the meter. Over time we have had some people in this group who need to be above 2.5 or even above 3.0.
Once your weekly dosage is found, from time to time you may still need to adjust half a pill per week, up or down, for the dips and spikes.
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The other reason I have read that they keep you higher-the 2.5-3.5 range -is if you have a mechanical heart valve. Retired Navy -can you provide me with the info on the low dose coumadin-or is it just a trial? Bleieve it or not, I am seeing a hematologist for the first time since this all started nearly 2 years ago -just wanted to ask him questions and wanted to make sure I had appropriate info! Blessings, Teri
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Well looks like I'm going to find out what happens if you have a high INR. Went to the clinic this morning and they did 2 finger prick tests and both came back >8. Apparently the machine only reads up to 8 so who knows what it is. They have taken a blood sample and sent it to the hospital so I suppose I wait to hear results and what the management plan is later today. The only thing I've been told so far is to stop taking the warfarin and don't drive anywhere today or tomorrow. I'll keep you posted!
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Wo!!!!
Do I read that correctly? Your present INR is 8.00 or maybe higher. Yes some Dr. are more relax about certain levels, but 8 OR HIGHER, I would be a tad more concerned. This whole high INR is indeed tricky, some good fellows will immediately jump on the "Hold pattern" but the problem with that is you can overshoot the low end of the target and have to re-work going back up, you know, like the swing of the pendulum. Instead, others will gradually lower your dosage so that you don't overshoot the target. Let us know the outcome, maybe today would be a good day to have more vitamin K. personally, THAT'S what I would do.
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Yep Denis I am going for a mega Vit K day! Lots of rocket, salad, green veggie stuff everywhere! I've been missing pigging out on salads since I've been on the warfarin so at least there is some small positive thing out of all of this!
I think you're right Denis there are two schools of thought. Bring it down quick with Vit K and risk going too low or come off warfarin and let drop slower but hopefully with a view to stopping before too low. I'll see in a couple of hours what my med team want to do about things so will let you all know.
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Wow, how exciting! Real-life example. Thanks, travelnut for trying this out for us :-D
Will check in later tonight for the next episode...
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Travel were you on Coumadin/Warfarin before? Without such extremes? If so did something change, like other meds or supplements? Just wondering so we'll all know one more thing to look out for. Godspeed to you.
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I am sorry to hear of your troubles with your INR. When mine has gone over 6. the doctor just said the same thing he told another post stop the blood thinner for a day and then go to a different dose for a week and then it was checked again. The dr. also said if you fall you MUST GO TO THE HOSPITAL NOW and be check out. other then that, that is all I have been told to do.
But like others have said it takes time to get your INR set. And it never is reaslly set because of the drug it's self. Keep us posted. Also I too could not stand not having any greens so I had some spinach the other day. Oh that tasted so good. Take care, mnmmom
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Haha, I'm not the healthiest eater but I do have vitamin-K rich food at least every other day. My rule is not to eat a whole plate full but rather have it as a side and it seems to work for me.
Travelnut, is everything ok with you?
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