[shoeshine]

Been for another blood test today and I asked if the INR target was set at different levels for different people. Apparently they are.

Are you precribed Warfarin? If so, do you know your medical INR target?

My target is 2.5.............

And other peeps, yes I know it's also used for vermin control......that's probably why they gave me the tablets in the first place......

But feel free to tell a few Warfarin/Vermin jokes if you wish, we users may be thin-blooded but thickskinned.............

[Speedy_Jim]

My girlfriend's INR target was 2.0. Took lots of trial and error with the dosage to get it stable - it fluctuates a lot. She ended up having different amounts each day of the week to make up to a weekly average of some very un-round number.

The amount you drink makes a big difference to stability - it's better to drink a constant amount (like 1 glass of wine per day) or cut it out entirely, than to drink as and when you feel like it. Oh, and make sure to drink plenty of water

[shoeshine]

Originally Posted by Speedy_Jim

My girlfriend's INR target was 2.0. Took lots of trial and error with the dosage to get it stable - it fluctuates a lot. She ended up having different amounts each day of the week to make up to a weekly average of some very un-round number.

The amount you drink makes a big difference to stability - it's better to drink a constant amount (like 1 glass of wine per day) or cut it out entirely, than to drink as and when you feel like it. Oh, and make sure to drink plenty of water

I was introduced to it over 2 yrs ago. I was attending blood rests every week, and yes it takes quite a while to stabilise........for the last nearly 12 months, my tests have been cut back to once every 2 to 3 months. I agree with the other advice Speedy_Jim. Thanks for responding here.

[neeeeeeeeeek]

I know you can't take quite a few herbal suppliments if your taking Warfarin, and certainly don't take St Johns Wort. Don't know much else tho.

[Jimbob1989]

My step grandfather takes them, they cause him a lot of trouble and make operations a pain.

[shoeshine]

Originally Posted by neeeeeeeeeek

I know you can't take quite a few herbal suppliments if your taking Warfarin, and certainly don't take St Johns Wort. Don't know much else tho.

I believe vitamin E supplements are to be avoided, and also Cranberry Juice.

Unfortunately the multivitamin pills always seem to contain vitamin E........so they are out.

[shoeshine]

Originally Posted by Jimbob1989

My step grandfather takes them, they cause him a lot of trouble and make operations a pain.

Also certain Dental Treatments can be a problem too.........

[sheff_minx]

Caused a lot of problems for my grandad aswel. But that was down to the inadequacy of the doctors who were treating him at the time rather than the drug itself which did its job perfectly (the problem was that my grandad didn't actually need to take Warfarin in the first place )

[uncleheed]

Cant have cranberries.Juice either.

Dont know why,but the missus was on it last year (DVT treatment),and there was quite a list of stuff she couldnt have

[bladesgirl]

I have been on Warfarin now since I had a DVT last July, my INR target is 2.5 I still go for blood tests every few weeks.

[shoeshine]

Originally Posted by bladesgirl

I have been on Warfarin now since I had a DVT last July, my INR target is 2.5 I still go for blood tests every few weeks.

2.5..........snap..we have 2 things in common, bladesgirl

I usually go to Rotherham General Hospital for mine, but will be switching to my local Doctor's Surgery soon. I will miss the staff at RGH, they have been great.........

[bladesgirl]

Originally Posted by shoeshine

2.5..........snap..we have 2 things in common, bladesgirl

I usually go to Rotherham General Hospital for mine, but will be switching to my local Doctor's Surgery soon. I will miss the staff at RGH, they have been great.........

well i go to the Nothern general for mine and its a nightmare sometimes i have to wait hours for them to take my blood, actually might think about going to my local surgery too

[emmie]

i work testing peoples INRs and other blood tests and the targets vary depending on the reason you were put on the drug in the first place. INRs also fluctuate from drug interactions and other stuff. alcohol especially affects it because of the effect on the liver. the clotting factors affected by warfarin are produced in the liver

[Don_Kiddick]

Originally Posted by shoeshine

2.5..........snap..we have 2 things in common, bladesgirl

I usually go to Rotherham General Hospital for mine, but will be switching to my local Doctor's Surgery soon. I will miss the staff at RGH, they have been great.........

I used to run this clinic about 10 or 11 years ago!


I noticed that people on warferin started behaving like vermin after a while - snappy, short fused, always wanting to be first in line, impatient...


You'll see

p.s. Your International Normalised Ratio would normally be 1
When things go awry with the clotting mechanism for what ever reason (it could even be cardiac - like Atrial Flutter) the INR needs to be raised (or ''thinned'') to prevent clots forming as the blood can be described as 'stickier' .

[bladesgirl]

Originally Posted by Don_Kiddick

I used to run this clinic about 10 or 11 years ago!


I noticed that people on warferin started behaving like vermin after a while - snappy, short fused, always wanting to be first in line, impatient...


You'll see


p.s. Your International Normalised Ratio would normally be 1
When things go awry with the clotting mechanism for what ever reason (it could even be cardiac - like Atrial Flutter) the INR needs to be raised (or ''thinned'') to prevent clots forming as the blood can be described as 'stickier' .

ha thanx for that buts its already happened


ps. yes thats true as when i had my dvt my INR was 1.1

[Don_Kiddick]

DVT's can often be a blob of free floating cholestorol that breaks away from the wall of a blood vessel & travels round the body, collecting platelets (clotting cells) along the way.
Eventually it lodges in a vessel that it can no longer pass through. Where it 'sets'.
Thus blocking the vessel. These can occur anywhere.

in the limbs they are referred to as DVT (deep vein thrombosis), in the brain would cause a stroke, in the lungs would be called a pulmonary embolism & in the heart would be called a heart attack (or infarction).

These are the most common sites.

Stay healthy folks - they're potentially fatal

[medic25uk]

some good posts here..

Agree with the comments regarding alcohol and warfarin... alcohol doesnt have a direct effect (to my knowledge) on warfarin but induces the enzymes in the liver that are required to break the drug down.... therefore fluctuant enzyme levels from binge drinking will lead to unstable INR results!
(The other major factor ofcourse is people that get drunk fall over -which is not so desirable with 'thinner' blood!)

There are other drugs that have this effect on liver enzymes which is why you should always check with your pharmacist/dr and avoid any homeopathic/unlicensed remedies if you are unsure what they contain.

Vitamin K is used in forming clotting proteins in the blood. Warfarin acts by inhibiting vitamin K.... Therefore any high dose of this vitamin will have the unwanted effect of 'thickening' the blood! -we actually use vitamin K to reverse high levels in overdose.

Peoples prescribed INR levels vary depending on what the indication for anticoagulation is. 2-2.5 is very common and used for atrial fibrillation or first time DVTs... however people with metallic heart valves may have a prescribed level up to 4.5...... i have seen levels above 20 in accidental overdose.

Deciding who should get warfarin is a very difficult. It is a fine balance between the benefits of treatment against the risk of potential harm ... especially in the elderly who are more likely to fall or suffer (for example) bleeding stomach ulcers from their arthritis medication. Therefore there are often people that i would like to prescribe warfarin that dont get it... and im sure there are some that might get it when actually they may be in a higher risk group of complications of treatment -its a judgement call.

hope this helps those of you that are interested!

[bladesgirl]

you sound like a doctor or something

[shoeshine]

Originally Posted by Don_Kiddick

I used to run this clinic about 10 or 11 years ago!


I noticed that people on warferin started behaving like vermin after a while - snappy, short fused, always wanting to be first in line, impatient...


You'll see

p.s. Your International Normalised Ratio would normally be 1
When things go awry with the clotting mechanism for what ever reason (it could even be cardiac - like Atrial Flutter) the INR needs to be raised (or ''thinned'') to prevent clots forming as the blood can be described as 'stickier' .

My problem was atrial fibrillation, and further tests at RGH showed I had sufered a "silent" heart attack. Hence the warfarin.

In response to bladesgirl and the situation at NGH, at Rotherham there is an appointments system which works well. I usually attend at 1.00pm (parking a bit easier) and get immediate attention, the Clinic is usually empty.

I would stay with them, but I am moving over to the local service after being refused urgent dental treatment just before Easter at my local Dentists.....excuse was they would need to have my up-to-date INR level and remove the tooth within 24hrs of the result. They also refused penicillin, with the excuse that it affects INR levels. Last year when a similar situation arose, another dentist at the same practice issued penicillin quite happily

At RGH they do the test in the afternoon, and ring me within 3-4 hours if a change in warfarin levels is necessary. My "Yellow Book" is posted the same day. No phone call in the afternoon tells me that nothing drastic has happened to the INR level.....it's great. I hope the move away from them is not a backward step.......

[shoeshine]

medic25UK, thanks for you post...........a great and interesting summary which has explained a few things to me..