I'm with you that it seems like splitting up the days that you don't take the warfarin seems like a good idea.

If I hold for two days, I'll drop about three points. I've only done it once ... I was at 4.8 and held for two days and dropped to 1.8. Now, if I'm a notch too high (say 3.3 or so) and they tell me to hold for two days, I won't do it just because I know I'll drop too low with that big a change. For me, I've found that holding for one day is usually enough to bring me down into range.

I mean, everyone is different so you might have a different reaction to holding for two days. Some folks just don't drop as fast as I do. I think I would call back and ask if you can spread out the "no med" days. I know you don't take much of the med at all and it seems like it would be out of your system pretty quickly. I'd be wary of holding for two days in a row too. Can you ask to talk to the doctor? Sometimes the nurses just don't have a good idea how this will really play out.

My hub has to take 4mg weekdays and 3mg sat and sun. His INR check is usually during the week. I understand what you say, maybe you might need to talk to the nurse and ask for a check on a day thats different.

Yea I'd get confirmation on those instructions because sometimes things get mistranslated between the doctor and the nurse. However, this may make sense given it appears your body requires very little warfarin to anticoagulate your blood.

I'm on 13mgs a day right now, and if I stopped taking my meds for 2 days, I usually only see a slight drop. Everyone reacts differently, and a lot of it is experimentation to see how it's all going to shake out.

By the way, while most INR ranges are between 2-3, many doctors, including my own, are much more comfortable with an INR sitting at 2.1 or 2.2 than 2.7 lets say.

I also would double check this order. If they want to keep it consistent it seems like you wouldn't want to hold back to back days. Something more like Tuesday and Friday or Saturday off makes more sense to me, just in terms of consistency.

I take 8mg a day and that keeps me pretty steady between 2.1-2.5. There have been a couple times I have had to go without meds for 2-3 days and my INR drops back down to almost normal so I know for me skipping back to back days would be detrimental.

Obviously everyone is different but never be afraid to question you doctor's orders if they seem strange or wrong to you. It's your health and body, not theirs, so make sure you are doing what's best for you.

I take 4.5mg - so 4mg one day, 5mg the next. The half mg seem hard to get in the UK where I am - I don't know why. Maybe they just don't prescribe it unless you complain. Haven't had to hold off any days so sorry I cannot help there. My INR has been between 2-3 most of the 6 months, was over 3 twice. Ironically is has only ever been spot on at 2.5 target on my last test last week!!! I was happier when it was lower - it worried me when over 3 in case of bleeds.

Thank you for all of the replies. I feel a little better that I'm not off base with my thoughts.

Last week after my 2 days of not taking the pill, I had my chest pains return. It's been 4 months since my PE and I've been feeling absolutely great. It came out of nowhere. I didn't know my INR reading at that time, so as far as I knew I was still around 3.0, so I don't think I was anxious about it.

If my INR did drop down closer to normal on the 2 days off, is it possible that my chest pain could come back? It sure seems to me like my clots should be totally gone 4 months after my PE. I took a pill that night and the chest pains didn't come back the next day. I haven't felt anything since, so I haven't called the doctor to ask about it. I think this experience is now part of why I am thinking I shouldn't take 2 days off.

I think I'll definitely call the doctor and let him know that I have switched myself to Wed / Sat off and see if he thinks this is OK.

Thanks again!