Hopefully RetiredNavy will chime in. He's been in range between 1.5 and 1.8 for years now and has not re-clotted. I think he was part of the PREVENT study that was originally done to study the effectiveness of using slightly lower dosages and INR ranges.

Here's a summary of the study from the National Institutes of Health:

http://www.nlm.nih.gov/databases/alerts/warfarin.html

I don't know if this would have more information for you---- another recent thread here:

http://www.dailystrength.org/c/Pulmonary_Embolism/forum/14581775-listen

PREVENT or long-term low intensity warfarin therapy is a great alternative for those on life-long anticoagulation therapy. However, not all patients are good candidates for PREVENT. Some people naturally require a higher INR to prevent clotting reoccurence then the low target INR of 1.5 to 2.0 used in PREVENT. If your doctors feels you are a good candidate, then it's worth trying. I find some of the troublesome symptoms that most patients complain about when it comes to Coumadin to be less troublesome (less fatigue, more controllable bleeding - still present but more controllable).

I am Factor V Leiden Homozygous and have had clots in 1992 (DVT/PE) and 1995. From 1999-2000 I had come off Coumadin and kept having reoccurent superficial clots. Dr. Goldhaber who is my thrombophilia doc asked me to take part in the PREVENT trial. I've been on it since 2001 and have remained clot free. Here is the New England Journal of Medicine article as another resource in addition to what TnT had offered:

http://www.nejm.org/doi/full/10.1056/NEJMoa035029

My INR stays around 1.8 though it occasionally has gone to 1.5 (1.4 even once). It doesn't take much to get back to your target INR if is it slowly low or slightly high.

Thank you all so much for posting! Cave76, I appreciate your research abilities! And TossNTurn, good link. I am printing it out for my other physicians. Thank you Retired Navy for jumping in. Your case history gives me encouragement....that you were actually one of the participants! I am leaning more and more towards this route. My hematologist has stated it's not wrong to stay on the Coumadin, but it would be okay to try to go off it too. My primary is the one offering the subtherapeutic route....he really wants me to try that. I had some unexplained symptoms in the year and half before the diagnosed DVT/PE and there is some wondering now if a PE was missed with some undiagnosed chest pain. Even when I presented myself to the ER with the diagnosed ones, I walked in and was in good shape at that point. The ER dr was convinced I had hurt my leg exercising but did the ultrasound to put my mind at rest. Then the CT of lungs was done again, just to rule out since I related some chest pain the previous few days....and there the clots were. I wasn't really SOB at that point. I was like RMB who got SOB afterwards. Thanks again everyone!

Hi,
I am going that way right now, still a little doubtful about it all,as you'll see in my posts..lol...but I am in the same boat, hema says no and doc says yes..so for now I follow the one I know and trust, our stories are very similar.