Guest guest Posted October 19, 2005 Report Share Posted October 19, 2005 I have been on Warfarin 7.5 MG OD for four months and my most recent PTT was 1.19. My doctor is surprised by this and never sen a PTT that low for that dose of Warfarin. There is only one more step up on a single pill dose to 10 MG OD. Has anybody else seen this? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 19, 2005 Report Share Posted October 19, 2005 " mjohn2002us " <john2003@o...> wrote: > > I have been on Warfarin 7.5 MG OD for four months and my most recent > PTT was 1.19. My doctor is surprised by this and never sen a PTT that > low for that dose of Warfarin. There is only one more step up on a > single pill dose to 10 MG OD. > > Has anybody else seen this? > Hi, 1.19 is low (I've never seen one described with two decimal points.) but there are so many foods and supplements that can affect your INR results that I'm not surprised. Wait until your doctor has seen hundreds of patients on warfarin, the variety of doses and results will no longer be surprising. 10mg is the highest single pill available, but lots of people take more than one pill a day. My last INR was 1.9, taking a rotation of 12.5, 12.5 and 10. Now I am taking 12.5 mg a day to try to push my INR up past 2.0. My father has had to take up to 15mg daily to stay therapeutic, but currently he's on 13.5mg per day. BTW, my PTT before I even started taking wafarin was 1.6. I don't know what the average number for people not on anti-coagulants is. Helena Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 19, 2005 Report Share Posted October 19, 2005 > > I have been on Warfarin 7.5 MG OD for four months and my most recent > PTT was 1.19. My doctor is surprised by this and never sen a PTT that > low for that dose of Warfarin. There is only one more step up on a > single pill dose to 10 MG OD. > > Has anybody else seen this? Hello, I, too, have trouble with my PTT, so I did some research on Vitamin K. I found that the dreaded " K " can be produced in ones gastro- intestinal track from those bacteria that we all need there. The bacteria is aided by cultured milk products like yogurt and buttermilk (two of my favorites). I have stopped consuming these and I hope to see a difference when I go for my next PTT this Friday. Last PTT 1.7. I also read that the average healthy adult has a PTT of 1.0 (without blood thinners). Dee Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 19, 2005 Report Share Posted October 19, 2005 Every person's dose is different. 7.5 mg could be a very low dose for an individual, while very high for someone else. I encountered people whose protime is just right at 2.2 on 2 mg of Coumadin and others at 1.2 on 10 mg. Usually 2.5 mg pills are prescribed so the dose can be increased by 2.5 increment. The dose does not need to be in one single pill. Helena wrote: " mjohn2002us " <john2003@o...> wrote: > > I have been on Warfarin 7.5 MG OD for four months and my most recent > PTT was 1.19. My doctor is surprised by this and never sen a PTT that > low for that dose of Warfarin. There is only one more step up on a > single pill dose to 10 MG OD. > > Has anybody else seen this? > Hi, 1.19 is low (I've never seen one described with two decimal points.) but there are so many foods and supplements that can affect your INR results that I'm not surprised. Wait until your doctor has seen hundreds of patients on warfarin, the variety of doses and results will no longer be surprising. 10mg is the highest single pill available, but lots of people take more than one pill a day. My last INR was 1.9, taking a rotation of 12.5, 12.5 and 10. Now I am taking 12.5 mg a day to try to push my INR up past 2.0. My father has had to take up to 15mg daily to stay therapeutic, but currently he's on 13.5mg per day. BTW, my PTT before I even started taking wafarin was 1.6. I don't know what the average number for people not on anti-coagulants is. Helena Web Page - http://www.afibsupport.com List owner: AFIBsupport-owner For help on how to use the group, including how to drive it via email, send a blank email to AFIBsupport-help Nothing in this message should be considered as medical advice, or should be acted upon without consultation with one's physician. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 19, 2005 Report Share Posted October 19, 2005 > > I have been on Warfarin 7.5 MG OD for four months and my most recent > PTT was 1.19. My doctor is surprised by this and never sen a PTT that > low for that dose of Warfarin. There is only one more step up on a > single pill dose to 10 MG OD. > > Has anybody else seen this? > Yes indeed I was on wafarin for 6 months and couldn't get my PT where the Dr's wanted it.I finally asked and insisted my Dr. prescribe Coumadin (brand)....within a week I was in the range they were looking for I maintain 2.3....2.5.. on 2.5 mg.two days and 3.75 all the rest. Virginia Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 22, 2005 Report Share Posted October 22, 2005 A: Whenever an INR value is significantly higher or lower than usual in a patient whose INRs have been relatively stable and well controlled, the following reasons should be considered by patient and physician: Lab error: Was the out-of-line INR a lab error (significant trouble at the time of blood draw with tissue trauma before blood could be obtained; the blood tube was not filled appropriately)? It may be indicated to repeat the test to confirm that the INR is out of line. New prescription medication: Has any new prescription medication been started or has any old medication been discontinued? Over-the-counter medications: Is the patient taking any new types of over-the-counter medications, vitamins, herbs, homoeopathic medications, weight control pills? Time of medication intake Is the patient taking his/her various medications at the same times as always or are any medications taken closer to the time when the coumadin is taken? Some drugs interfere with the absorption of coumadin and should therefore not be taken at the same time. Diet: Have there been dietary changes that would change the patient's vitamin K intake? In my opinion, a patient should be familiar with the approximate vitamin K content of the foods that he/she eats. Infection : Has the patient recently had an infection or diarrhea? Both can increase the INR. Compliance: Has the patient really taken his/her medication or has he/she taken too much warfarin? Since various generic warfarin preparations and coumadin all look different, the switch from one drug to the other can lead to incorrect medication intake. Lupus anticoagulant: Does the patient have a lupus anticoagulant? In some patients the lupus anticoagulant can have an influence on the INR. Since lupus anticoagulant levels can fluctuate over time, the INR can fluctuate as well. Furthermore, if the lab changes its reagents or the INR is tested in different labs, discrepant INR results are possible in some patients with lupus anticoagulants. Shelf life: Was the coumadin outdated? Efficacy of the drug is only guaranteed for the time printed on the package. The drug may loose efficacy thereafter. Stress, physical activity : Has there been an unusual amount of stress, sleep deprivation, or physical activity in the days preceding the INR test? While I am not aware of any published data on this issue, it is possible that in some patients there may be an influence on the INR (increase or decrease), possibly through an influence on the metabolism of coumadin. Generic warfarin: Could (a) taking generic warfarin, or ( switching from brand coumadin to generic warfarin or vice versa, or © switching from one type of generic warfarin to another generic warfarin explain INR fluctuations? Unlikely. Studies indicate that generic warfarin and brand coumadin are equally effective and bioequivalent, i.e. for example 5 mg coumadin leads to the same INR as 5 mg generic warfarin [reference 1]. However, an individual patient assessment is needed, with correlation of INR values to the time of use of generic warfarin or brand coumadin, to help clarify whether the fact that a patient is taking generic warfarin may play a role in the INR fluctuations. Southern Medical Journal 2001;94:16-21 ************************************** I have had a few physicians tell me that Coumadin is more reliable in maintaining a stable INR. Ellen *************************************** I have been on Warfarin 7.5 MG OD for four months and my most recent PTT was 1.19. My doctor is surprised by this and never seen a PTT that low for that dose of Warfarin. There is only one more step up on a single pill dose to 10 MG OD. Has anybody else seen this? *************************************** Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 22, 2005 Report Share Posted October 22, 2005 A: Whenever an INR value is significantly higher or lower than usual in a patient whose INRs have been relatively stable and well controlled, the following reasons should be considered by patient and physician: Lab error: Was the out-of-line INR a lab error (significant trouble at the time of blood draw with tissue trauma before blood could be obtained; the blood tube was not filled appropriately)? It may be indicated to repeat the test to confirm that the INR is out of line. New prescription medication: Has any new prescription medication been started or has any old medication been discontinued? Over-the-counter medications: Is the patient taking any new types of over-the-counter medications, vitamins, herbs, homoeopathic medications, weight control pills? Time of medication intake Is the patient taking his/her various medications at the same times as always or are any medications taken closer to the time when the coumadin is taken? Some drugs interfere with the absorption of coumadin and should therefore not be taken at the same time. Diet: Have there been dietary changes that would change the patient's vitamin K intake? In my opinion, a patient should be familiar with the approximate vitamin K content of the foods that he/she eats. Infection : Has the patient recently had an infection or diarrhea? Both can increase the INR. Compliance: Has the patient really taken his/her medication or has he/she taken too much warfarin? Since various generic warfarin preparations and coumadin all look different, the switch from one drug to the other can lead to incorrect medication intake. Lupus anticoagulant: Does the patient have a lupus anticoagulant? In some patients the lupus anticoagulant can have an influence on the INR. Since lupus anticoagulant levels can fluctuate over time, the INR can fluctuate as well. Furthermore, if the lab changes its reagents or the INR is tested in different labs, discrepant INR results are possible in some patients with lupus anticoagulants. Shelf life: Was the coumadin outdated? Efficacy of the drug is only guaranteed for the time printed on the package. The drug may loose efficacy thereafter. Stress, physical activity : Has there been an unusual amount of stress, sleep deprivation, or physical activity in the days preceding the INR test? While I am not aware of any published data on this issue, it is possible that in some patients there may be an influence on the INR (increase or decrease), possibly through an influence on the metabolism of coumadin. Generic warfarin: Could (a) taking generic warfarin, or ( switching from brand coumadin to generic warfarin or vice versa, or © switching from one type of generic warfarin to another generic warfarin explain INR fluctuations? Unlikely. Studies indicate that generic warfarin and brand coumadin are equally effective and bioequivalent, i.e. for example 5 mg coumadin leads to the same INR as 5 mg generic warfarin [reference 1]. However, an individual patient assessment is needed, with correlation of INR values to the time of use of generic warfarin or brand coumadin, to help clarify whether the fact that a patient is taking generic warfarin may play a role in the INR fluctuations. Southern Medical Journal 2001;94:16-21 ************************************** I have had a few physicians tell me that Coumadin is more reliable in maintaining a stable INR. Ellen *************************************** I have been on Warfarin 7.5 MG OD for four months and my most recent PTT was 1.19. My doctor is surprised by this and never seen a PTT that low for that dose of Warfarin. There is only one more step up on a single pill dose to 10 MG OD. Has anybody else seen this? *************************************** Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 22, 2005 Report Share Posted October 22, 2005 A: Whenever an INR value is significantly higher or lower than usual in a patient whose INRs have been relatively stable and well controlled, the following reasons should be considered by patient and physician: Lab error: Was the out-of-line INR a lab error (significant trouble at the time of blood draw with tissue trauma before blood could be obtained; the blood tube was not filled appropriately)? It may be indicated to repeat the test to confirm that the INR is out of line. New prescription medication: Has any new prescription medication been started or has any old medication been discontinued? Over-the-counter medications: Is the patient taking any new types of over-the-counter medications, vitamins, herbs, homoeopathic medications, weight control pills? Time of medication intake Is the patient taking his/her various medications at the same times as always or are any medications taken closer to the time when the coumadin is taken? Some drugs interfere with the absorption of coumadin and should therefore not be taken at the same time. Diet: Have there been dietary changes that would change the patient's vitamin K intake? In my opinion, a patient should be familiar with the approximate vitamin K content of the foods that he/she eats. Infection : Has the patient recently had an infection or diarrhea? Both can increase the INR. Compliance: Has the patient really taken his/her medication or has he/she taken too much warfarin? Since various generic warfarin preparations and coumadin all look different, the switch from one drug to the other can lead to incorrect medication intake. Lupus anticoagulant: Does the patient have a lupus anticoagulant? In some patients the lupus anticoagulant can have an influence on the INR. Since lupus anticoagulant levels can fluctuate over time, the INR can fluctuate as well. Furthermore, if the lab changes its reagents or the INR is tested in different labs, discrepant INR results are possible in some patients with lupus anticoagulants. Shelf life: Was the coumadin outdated? Efficacy of the drug is only guaranteed for the time printed on the package. The drug may loose efficacy thereafter. Stress, physical activity : Has there been an unusual amount of stress, sleep deprivation, or physical activity in the days preceding the INR test? While I am not aware of any published data on this issue, it is possible that in some patients there may be an influence on the INR (increase or decrease), possibly through an influence on the metabolism of coumadin. Generic warfarin: Could (a) taking generic warfarin, or ( switching from brand coumadin to generic warfarin or vice versa, or © switching from one type of generic warfarin to another generic warfarin explain INR fluctuations? Unlikely. Studies indicate that generic warfarin and brand coumadin are equally effective and bioequivalent, i.e. for example 5 mg coumadin leads to the same INR as 5 mg generic warfarin [reference 1]. However, an individual patient assessment is needed, with correlation of INR values to the time of use of generic warfarin or brand coumadin, to help clarify whether the fact that a patient is taking generic warfarin may play a role in the INR fluctuations. Southern Medical Journal 2001;94:16-21 ************************************** I have had a few physicians tell me that Coumadin is more reliable in maintaining a stable INR. Ellen *************************************** I have been on Warfarin 7.5 MG OD for four months and my most recent PTT was 1.19. My doctor is surprised by this and never seen a PTT that low for that dose of Warfarin. There is only one more step up on a single pill dose to 10 MG OD. Has anybody else seen this? *************************************** Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 23, 2005 Report Share Posted October 23, 2005 Thanks Dee:-) > > > > > > I have been on Warfarin 7.5 MG OD for four months and my most > recent > > > PTT was 1.19. My doctor is surprised by this and never sen a PTT > that > > > low for that dose of Warfarin. There is only one more step up on > a > > > single pill dose to 10 MG OD. > > > > > > Has anybody else seen this? > > > > > > Quote Link to comment Share on other sites More sharing options...
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