I think everyone is different in terms of how they metabolize it. I'm on 7.5 everyday, then 10 mg on Wednesdays.

You are so lucky..I am on 11mg and keep going higher, one day a week i take either 12 or 13...I would love to be on 1,2 hell even 5 mgs..lol... it comes down to how your body metabolizes it,Every doc has said do not worry about how much you are taking., it is not important, the INR is the only thing that matters, as long as your theraputic thats all the counts :)

I used to work with a woman whose husband took 2mg a WEEK to stay in range. She found out that I took 6mg daily and about flipped because it seemed so high to her.

Really, the point with warfarin is not how much (or how little) you have to take to stay in range ... the point is just to stay in range!

Yeah, you're on a low dose, but if it is working, just stick with it. It is possible that the further out you get from your clots and the more active you become, the higher your dose will get. Maybe not much higher, though. No guarantees you'll stay at this dose for the entire six months.

M2LR is right that everyone metabolizes differently and lots of us are taking other meds that affect how much warfarin we have to take. There are a billion and one things that affect warfarin, so I wouldn't get too hung up on the dose.

I take 14mg daily. My dr says I take the highest dose of any patient he knows.

I take 14mg three times a week and 13mgs 4 times a week, and I've been as high as 15mgs 7 days a week. Dosage doesn't matter; it's your INR that matters, so whatever your body needs is what is right.

I know some folks who take as much as 20mg per day (they have APS) just to stay within the therapeutic targe range. Some people require less, it's all depends on how that persons body processes things.

I am on Preventative long-term dosing (lifetime) which has a target range of 1.5-2.0 For me 7.5mg per day is required just to stay in that low target INR.

If you only need to take 2mg or less to stay therapeutic, that's awesome it means your body responds well to coumadin therapy. The average person will need 7.5mg (give or take).

Tom, is it normal for people who have APS to need higher doses of warfarin? I mean, I kind of assume based on what you said - but what's the reason for that?

Oh, and Aussie - I had a friend who couldn't even take warfarin because she was so sensitive to it. She had to take injections only for her months of anticoagulation treatment.

Aussie----- Do you mean 2 mg or less DAILY? I'm not sure I understand completely.

I take 2.5 mg per day five days of the week and 5 mg for 2 days a week and I stay therapeutic 99% of the time with only a very occassional small dip higher or lower.

Yes, there are some people who are incredible 'sensitive' to most medications. I'm one of them. I'm sure that's because of genetic make-up and perhaps when genetic testing becomes the norm dosing will become tailored to each person.

I have learned over the years that if a 'normal' dose (of a med) is perhaps 20 mg. then I start much much lower and ramp up, trying to reach the 20 mg.
That would NOT work with some medications (such as warfarin!) but it does with some. I just used that as an example and is not to be considered medical advice.

If you can stay therapeutic with a very small dose---- count yourself lucky! (grin)

A fairly large majority of APS patients need a higher INR then the 2.0-3.0 target range to prevent reoccurence. As result, they are also taking a higher daily dosage.

Again, this does not mean that every single APS patients falls into this category, but, for a lot of them, they tend to need a higher INR as compared to rest of us with other clotting disorders.

The 2.0-3.0 target INR is still the standard starting point for all APS patients. There had been discussions within the medical community about extending the target INR to 3.0-4.5 but a research report back in the 2007 timeframe had rejected that concept as a standard protocol. The report concluded that as long as the patients Factor II levels while on normal therapeutic dosage remains less then 30%, the patient would not need to be on a the higher INR (3.0 or above). This recommendation was to prevent bleeding problems for patients who did not need the higher INR.

http://onlinelibrary.wiley.com/doi/10.1002/art.23111/pdf

On the other hand, a lot of specialist feel that the target INR for APS patients should be 3.0-4.5. This is discussed on the APS Foundation of America Website: http://www.apsfa.org/faq/faq2.htm

This is an interesting discussion! I was wondering how my dosage compared to others, especially since I want to start eating more veggies so I may need to take more warfarin.

I'm currently on 10 mg/day. I started on 5, but it didn't seem to do anything for me (my INR fell steadily for three weeks post-release until I landed back in the hospital with an INR of 1.09). 10 is working for now, but as stated, I may end up going higher.

Whoops - forgot the last line!

I meant to add that whatever works for you works for you. If it's 1, excellent! If it's 10, fantastic! As long as your doctor is aware of your tolerance or sensitivity, and your INR levels stay where they're supposed to be :)

dragon,

I eat a lot of veggies but keep an eye on the Vit K content. And I take only 2.5 for 5 days and 1 mg for 2 days.

That may or may not work for you. (my disclaimer)

Cave - yeah, I've become far too knowledgeable about Vit K content ;) I'm working on keeping to a weekly Vit K amount for now, and then I might up that in a few weeks, or I may not.

As it is, I'd rather take more medicine if I can have more veg. But my tastes usually switch over to "summer fruit season" about April, so who knows :)

Thanks everybody for your feedback. I guess the biggest problem with the low dose is it makes it harder to stay in range. A 0.5mg drop resulted in a half a point drop in my INR from 3.4 to 2.9, the smallest tablets i have a are 1mg and they can be broken in half too which is helpful. I'd say i'll need alternating dosage days as many of you have described to maintain the range.
Oh and by the way i am 14 days post PE and i am finally in range today for the first time - yahoo!!!!