Coumadin Dosages

[Cork]

Hi,
Im new to this forum and sorry if I'm asking a question that you may get all the time. Haven't really had a chance to read through all the topics.

I was wondering about how much coumadin people average a day to keep their INR therapeutic.

Is 12.5 mg per day a lot to keep an INR at or about 3.5?

Thanks

[ccrawford]

Cork - There is no right answer to your question because everyone is different. If you are active, then you will need more coumadin, if you eat a lot of green veggies, you will need more, if you are a large person, you will need more. Sometimes other medication can also affect how much you will need. Keep reading these posts and you will learn a lot about coumacin management.

[Ross]

Cork the Al Lodwick answer, he's our resident Anticoag expert and pharmacist, would be whatever it takes to keep you in your range is the correct dose. He's seen people as low as 1mg up to and over 20mg per day. The honest average, though it doesn't mean a thing is 5mg a day for most people.

You should wonder over to Al's site and check it out. Tons of information that you may not know is there. Here is he's statement right off of his site:

I take warfarin 5 mg every day. Is that a good dose? The proper dose of warfarin is the one that keeps your INR in the desired range. I've seen as little as 1 mg on four days per week and as much as 25 mg per day. They both were correct doses for the individuals involved.



www.warfarinfo.com

[Georgia]

In addition, how fast the liver processes the coumadin is individual. I only take 4/4.5 mg to keep my inr at 3 - 4. Your liver obviously processes/metabolizes it much more rapidly.

[LadyBlue]

I rotate between 2.5 mg and 5 mg every other day. That keeps my INR perfect. I am on a low dose and will eventually go off. I was put on in Jan 05 after a 2 week visit to Sweden and went into flutter. They suspect I was in flutter for weeks prior to even going away! I didn't know what it was, but I felt really, really sick!! I could barely walk 10 feet without having to stop! I had to walk 1/4 mile to the Wells Fargo to get money cabled to me from my family as I lost my wallet in a night club :o It took an hour. It was a struggle and I would make a game of seeing if I could make it from this lamp post to that park bench! It was HELL! I thought I was going to fall down and die in the street:confused:

I thought a pacer lead had come loose. I didn't even know what flutter was!
When I returned home and went to doc and he told me what was happening, and he put me on coumadin, and told me I was soooo lucky that I didn't have a stroke!:eek: I freaked! I had an eblation ( all these words are new to me ) in Nov 05, and all is well so far! I am on coumadin as a precaution, and doc will decide this month to take me off or not!

My other coumadin story. I accidently doubled my dose for about 4 weeks and I was bruising everywhere!! My cat would walk on me and my legs looked like a leapard!:eek: A little cut would bleed for hours. D'oh me! :mad:
I figured out what I was doing and called doc. I used 3 months of perscription in one month! I never had to take meds before and it was all new to me.

Now all is well and everything is normal. :)

I get my blood checked about 1 x a month ( I'm a needle phobic so doc has to pull teeth just to get me in for that!) I am learning that many of you check your INR regularly? How so? Should I do it more often? I live an hour away from Children's in Boston, and will not let anyone else take blood from me...butterfly needle you know..;)

LB

[geebee]

I get my blood checked about 1 x a month ( I'm a needle phobic so doc has to pull teeth just to get me in for that!) I am learning that many of you check your INR regularly? How so? Should I do it more often? I live an hour away from Children's in Boston, and will not let anyone else take blood from me...butterfly needle you know..;)
LB
If you stay in range, once a month is fine. I check mine weekly simply because I have a home tester and the test strips on hand to do so. Prior to home testing, I went in every 4-6 weeks as it was very inconvenient for me.

[ccrawford]

LB - I'm sure somewhere in Boston is a coumadin clinic that uses the finger prick method of testing. Get in the phone book and start calling cardiology groups and or coumadin clinics and you will find one. It only takes one large drop of blood from a finger to test you and you'll wear a band-aid on your finger for an hour or so.

[LadyBlue]

LB - I'm sure somewhere in Boston is a coumadin clinic that uses the finger prick method of testing. Get in the phone book and start calling cardiology groups and or coumadin clinics and you will find one. It only takes one large drop of blood from a finger to test you and you'll wear a band-aid on your finger for an hour or so.

Sooooo I don't need the vampire test each month? That is great info, thank you very much...I will look into it!:)

If you stay in range, once a month is fine. I check mine weekly simply because I have a home tester and the test strips on hand to do so. Prior to home testing, I went in every 4-6 weeks as it was very inconvenient for me.

What's a home tester? Is it like a diabetes test strip thing? More importantly, does it hurt?:)

[Blanche]

Oh, dear, dear, dear....It is my understanding that you do indeed need to be tested at least monthly, even if you are taking Coumadin for reasons other than valve replacement. You may be able to go to finger stick at an anticoagulation clinic, but it is my understanding that you must continue to be tested as long as you are on anticoagulants. Please do not stop testing on your own without consulting with your doctor.
Kindest regards,
Blanche

[geebee]

What's a home tester? Is it like a diabetes test strip thing? More importantly, does it hurt?:)
Yes, it is similar to a glucose testing meter except larger and more expensive. Many insurance companies will pay for it (or part of it depending on deductibles and copays) if you can prove necessity (i.e. travel a lot, fluctuation in INR so weekly testing is warranted, difficulty getting to a lab, etc.). Let me know if you need more info.

[Ross]

[QUOTE=LadyBlue]What's a home tester? Is it like a diabetes test strip thing? More importantly, does it hurt?:)


http://www.ptinr.com/data/templates/article_alt.aspx?z=5&articleid=234

[RandyL]

What's a home tester? Is it like a diabetes test strip thing? More importantly, does it hurt?:) [/COLOR][/QUOTE]

click on the QAS at the top of the page for home tester info

[traumahob]

I rotate between 2.5 mg and 5 mg every other day. That keeps my INR perfect. I am on a low dose and will eventually go off. I was put on in Jan 05 after a 2 week visit to Sweden and went into flutter. They suspect I was in flutter for weeks prior to even going away! I didn't know what it was, but I felt really, really sick!! I could barely walk 10 feet without having to stop! I had to walk 1/4 mile to the Wells Fargo to get money cabled to me from my family as I lost my wallet in a night club :o It took an hour. It was a struggle and I would make a game of seeing if I could make it from this lamp post to that park bench! It was HELL! I thought I was going to fall down and die in the street:confused:

I thought a pacer lead had come loose. I didn't even know what flutter was!
When I returned home and went to doc and he told me what was happening, and he put me on coumadin, and told me I was soooo lucky that I didn't have a stroke!:eek: I freaked! I had an eblation ( all these words are new to me ) in Nov 05, and all is well so far! I am on coumadin as a precaution, and doc will decide this month to take me off or not!

My other coumadin story. I accidently doubled my dose for about 4 weeks and I was bruising everywhere!! My cat would walk on me and my legs looked like a leapard!:eek: A little cut would bleed for hours. D'oh me! :mad:
I figured out what I was doing and called doc. I used 3 months of perscription in one month! I never had to take meds before and it was all new to me.

Now all is well and everything is normal. :)

I get my blood checked about 1 x a month ( I'm a needle phobic so doc has to pull teeth just to get me in for that!) I am learning that many of you check your INR regularly? How so? Should I do it more often? I live an hour away from Children's in Boston, and will not let anyone else take blood from me...butterfly needle you know..;)

LB
LB ,
UMASS Memorial has a finger stick clinic. How far are you from Worcester? Deb

[catwoman]

LB:

Go to acforum.org to find an anticoagulation clinic near you. Here's a link to clinic locations in Massachusetts. Check to find one that uses an CoaguChek or another small unit, rather than a lab draw. I'm sure these clinics use fingersticks instead of lab draw.

http://www.acforum.org/locations.html

[afraidofsurgery]

I take 7.5 mg/day and once in a while need an extra 2.5 mg to stay in range. This is only after a PT-INR test result and per the advice of my cardiologist.

I think I'm a bit on the high metabolizer side (ie, my liver likes to chew the stuff up faster than other people's livers), I was started out at 5 mg/day then went to 7.5 mg 2 days a week, then 3, etc. until now every day.

I just started on the South Beach Diet (written by a cardiologist!!) and am eating a lot more green leafy veggies so I'll probably need an upward adjustment again.

And yup - everyone's different, whatever it takes to stay in range and with the guidance of a medical professional who understands coumadin.

Patty

[Marty]

I'm old so need less than most folks on this website. My range is 19.5 to 21 mgm/wk. I adjust the dose with 2.5mgm and 3mgm tablets. for the last few weeks 21 mgm has kept me near my target INR 2.5.

[Bob M.]

I guess I am on the smallest dosage yet; I take from 2mg. to 2.5mg. and sometimes I go as low as 1mg. I'm a pretty thin fella, weighed 140lbs when I went in for AVR surgery and came out of the hospital weighing 128. Have gained about four lbs since that time, but it is slow going.

[BDMc]

When I first got stabilized after surgery, I was on 15mg per day. It has gradually dropped over the years, but I now take 12mg 5 days, and 11mg 2 days per week. Like Gina I used to get tested at the lab about every 4-6 weeks. I got a home tester in March, which requires weekly testing for my insurance coverage. I'm not very good at it yet, but like it much better. It can hurt a little, but is basically a pin prick. Brian

[Bob M.]

With respect to my earlier post, I am taking Amiodarone (200mg) which tends to "enhance" the warfarin effect. Perhaps this is why I am on such a low dose of Warfarin.

[Ross]

With respect to my earlier post, I am taking Amiodarone (200mg) which tends to "enhance" the warfarin effect. Perhaps this is why I am on such a low dose of Warfarin.
Certainly a large part of it. :)

[graciebeth]

Ive been taking 2mgs for 2days and 1mg the 3rd day for the past week, waiting on results from bloodwork this morning to see if thats a good combo or if we are changing again..

I have also tried 2mgs a day and then alternated between 2mgs and 1mg every other day..

Since Ive read that more activity is a reason to need to increase the mgs Im assuming that I may need more once I go back to work and so forth.

----Gracie

[Magnus]

I'm on 10 mg/day. What's weird is that the dosage has stayed the same even though I've put on 10 kg since surgery...

[allodwick]

Maybe the largest determinant of what warfarin dosage you need is the variation of the liver enzymes that you inherited from your parents. The smallest dose that I have seen is 1/2 of 1 1 mg tablet daily for a total of 3.5 mg per week. The largest is 25 mg per day for a total of 175 mg per week. I have heard of much larger doses, I just haven't seen anyone personally. Supposedly there is someone in the area where I live who takes 10 X 10 mg tablets daily - I just haven't seen him.