Hi,
I must be getting terrible at math.
It would add up to 6mgs total in a 48 hour period.
2mgs on Wednesday at 6PM
2 mgs Thursday at 3AM - 9 hours late
When should I take my next dosage?
Thanks

Have you discussed with your doctor what to do of you miss or are ver late on a dose? Most of the time, they say just skip the missed dose and return to normal dosing the next day, but that didn't work well for me because my INR plummeted once I missed a dose, so basically I need to never miss a dose, even if it means I'm taking two doses very close together. But that same thing won't necessarily work well for everyone, and since you're so worried about even slightly high INRs, I don't know that taking another dose so soon would be ideal for you. One thing I know for certain, I wouldn't want to feel stuck taking any medicine at 3am, so you're probably stick with either deciding to skip a dose or taking two doses close together. Personally, I don't think taking a second dose six hours earlier than the night before is going to make any big difference for you. I'm not someone who religiously takes my medication at exactly the same time every day, but my INR I still very consistent.

You might check with the pharmacist and see what he/she suggests.

Me, personally, I've done that a couple times. I usually take a half dose when I remember and then go back to my regular dosing schedule. You can expect a brief dip in your INR but you'll stabilize again in a few days.

I'd never skip a dose completely when my INR is in range ... skipping a dose will drop my INR almost two points, which is way too much (I'd drop from 2.4 to .4, for example). Everyone is different, of course, so checking with your doc or pharmacist is always a good idea.

Thanks for your responses.
I get up every two hours during the night because I take a mild diuretic for my BP. I think what I will do is take the dose at midnight tonight and then one hour earlier the next day and the next till I get back to my regular time of 6PM.
Sheesh, it took me 2 months to get in range and then I go and screw it up. That's what was so annoying.

Actually it sounds like you took 2 mg on Wed and 2 mg on Friday (3am). I did this once early on and called the pharmacist on what to do but don't remember what he recommended. I don't think it would hurt anything if you took it late tonight, say 11 pm, and then a few hours earlier than that tomorrow so they're all close to 24 hours apart and you're back on track by Sunday.

I've done it too. I just take it when I realize I missed it. So if I forget to take my dosage at my normal time (between 5pm and 8pm) and don't realize it until the next morning, I'll take the missed dosage in the morning, and then take my next dosage at the normal time. That has not caused me any problems. I think what a provider or pharmacist will generally tell you is that if you missed the dosage, take it as soon as you realize it, unless it's close to the time you're suppose to take your next dosage.

This is what is says on the National Health Service (UK) site:

If you forget to take your dose of warfarin in the evening but remember before midnight on the same day, take the missed dose. If midnight has passed, leave that dose and take your normal dose the next day at the usual time.

I'd also get your INR tested soon, depending on when you're due next.

Due to the long half-life of warfarin (20-60 hours), forgetting to take the dose on correct time does not matter that much (although it is useful to keep it as a routine, to ensure you will not miss a dose). It can take several days without taking warfarin for the risk of clotting to increase (i.e. INR to be well below theurapeutic levels).

The replies so far have provided good advice. What ever you do, if you miss a dose one day, I would not take a twofold dosage the next day in one go (i.e at the same time) as this can cause the INR to spike.

I know I am chiming in late, but what I normally would do in this case is take my next pill at bed time (10 - 11pm) the next night and then 8 pm the following night and then back to 6 pm on the 3rd night.

Well, I did something like that. I took the next pill at 11:15 the next night, then at 9PM the day after and last night 6PM.
I retest tomorrow.

Brooklin and Crash, that's what I do, too, only I've gotten really sloppy with it a few times recently, and sometimes make bigger mistakes. Like, I'll be 18 hours late. So then I will take the next day's dose 18 hours later instead of 24, whatever time of day that winds up being, then my next one 18 hours after that, and slowly work my way back to being on schedule.

Fortunately, there are some days when I take 2.5 mg instead of 5 mg. On those days, I compress the interval to 12 hours if I am in catch-up mode. But it's an incredible pain in the ass, I'm taking pills at all hours of the day, setting alarms on my phone, etc.

Moral of story: When you've been doing this for many years, you start getting careless despite your best intentions. If you were careless before, you tend to get even more careless later. One of my buddies on Warfarin got to the point where he couldn't remember if he'd taken it or not, was getting bruising, etc. He had a mild stroke, which had almost no effect on him, except he can't stand loud music now-- and he's much more careful about dosing.

Use a pill container. Have a system and stick to it.

I feel like such a moron admitting this happened to me, I should know better.

I use a pill dispenser as well as a reminder app. The last time I missed a dose it was a few days later when I realized I was one day out on my dispenser.

In that case I just shrugged my shoulders and carried on less the one dose a few days before (I wasn't even sure I know which dose I had missed). I tested again in about a week later and all was well by then.

I have to second the idea of the pill container and sticking to a system.

I have 5s and 1s in the house, because my dose is usually 5, 5.5, or 6. A few years ago, I didn't have a pill box and would just take the pill right out of the container at night. Somehow, I got mixed up and took 1s for a week, instead of 5s. My INR plummeted (of course) and it took some questioning by my doctor to realize that I'd been taking the pink pills instead of the peach ones.

That's when I switched to the pill box... haven't had a mixup like that since.

Yeah, I keep my weekly pill box on my bathroom counter on the side where my tooth brush is so I have a visual reminder. That way, when I brush my teeth before I go to bed, I can see whether I took the meds or not. Also, after taking my meds, I leave the lid up on the day of the week so I again have another visual that I didn't forget to take the meds. For those who have little kids, you probably need to be more careful leaving pills in their reach but putting them where you are sure to see them and take them is what helped me. I forget but that's usually only when I get distracted by something during my routine.

I'm on so many meds for another condition that I'd lose complete track if I didn't have a morning and night daily pill box.