View Full Version : Coumadin

12-31-2009, 03:52 PM
My wife is taking a high amount of coumadin 15 mg 6 days a week and 20 mg anybody else take that much or see that effect after treatment.

12-31-2009, 07:51 PM
Coumadin (warfarin) is well known for affecting individuals very differently and also for being affected by changes to other drugs being taken. I think the average dose is something like 10mg, but I seem to be sensitive and only take 2.5mg. So long as regular blood tests are taken to keep INR levels within range the actual dose required is not so important.

01-01-2010, 02:30 AM
I have no idea what the average dose is, but that dose sounds pretty high to me. I eat as many vitamin K-rich foods I want and only need 4 mg/day to keep my INR in range.

I wonder if your wife is taking a drug that blocks coumadin?

01-01-2010, 04:44 AM
Actually, the information I gave was wrong. The 10 mg dose I referred to is not the expected average that will be required, but just the starting dose for new patients. The expected maintenance dose is stated as being 2-5mg.
It might be worth checking some of the drug interactions, but don't change anything without supervision and blood tests!

01-01-2010, 05:26 AM
She has been on a high dosages since we have left the hospital it has come down but they can only say she needs it to control her INR which is check regularly. We have setup a appt to see a specialist at the clevelnd clinc in January. Dr. Lanford was available.

01-01-2010, 08:55 AM
Your in good hands with Dr Langford!

01-01-2010, 09:31 AM
You should definitely have a CC hematologist oversee your coumadin care. It can be tricky with Wegs. I'm sure Dr Langford will set that up, just thought I'd say it.

Now that Jack mentions it, that is exactly how the dosages go. It can take a couple months to really get her stable on a dose. But yeah, 10 mg is way high.

If the hematologist doesn't mention it, you should ask about getting a home INR tester. It's like a blood glucose monitor. Insurance requires that you are on coumadin for 3 months before they'll approve it. Then you test once a week with a finger prick. (No more often, since the test strips are about $13 each!) You call your results in to a service that supplies the machine and supplies. They let the doc know your INR. If it's fine, you just continue at your current dose. If it's too high/low, your doctor calls and makes adjustments. MUCH safer than having it checked once a month-- the usual protocol once the dosage is stable.

11-18-2010, 06:54 AM
There is quite a lot in the news over here at the moment about a replacement for Warfarin. See - Blood thinner warfarin faces promising new competition Health Jackal (http://www.healthjackal.com/health/2010/11/17/blood-thinner-warfarin-faces-promising-new-competition/)

11-18-2010, 07:19 AM
Sounds like a promising drug.

11-18-2010, 12:42 PM
Cool-- I read about the mechanism of action (because I'm a geek). It's very similar to injectable heparin (Lovenox).

11-18-2010, 12:51 PM
Im on 4mg of coumadin on tuesday through sat. and 5mg sunday and monday, but ive been having problems with my INR. doc wants me between a 2.5-3.0, recent check on thursday was at a 5.6! :ohmy: so doctor was a little worried, its tricky trying to get it to the right range.

11-18-2010, 02:05 PM
Are you sure the range isn't 2.0 - 3.0? That's the usual range for a history of clots. A range of 2.5 - 3.0 is extremely narrow and will be almost impossible to stay in.

How often are you getting your INR checked? Ask your doc about getting a home tester so you can do it weekly using a finger prick instead of a vein. Not all docs know about the home INR testers, so you might have to educate them. The testers are as accurate as vein puncture. I don't see him anymore, but the chief of hematology at JHU got me started on a home tester and it's made a big difference.

Also, are you using generic coumadin (warfarin)? Certain drugs should really only be used in brand name form, when the dosing needs to be precise, and small variances can cause big problems. The differences among generic warfarin manufacturers is great enough to keep you from stabilizing your INR. I had trouble stabilizing mine on generic warfarin. Finally my JHU hematologist put me on brand name Coumadin and I've never had trouble since. Here's a link to a thread I started about this. I included info from a JHU newsletter on why it's important to take brand name Coumadin.


11-18-2010, 06:29 PM
yupp 2.5-3.0 ranging around there, i told the doctor that it was a small range but thats what he insisted. im getting my INR checked once a week at the doctors office using the finger prick method, they were taking it from my veins but im a hard stick now as it is. i am on warfarin, and i havent been in the range once since ive been on it. its either been too high or two low. what brand name coumadin are you on?

11-18-2010, 09:37 PM
My target range is 2 - 3 and I'm fairly stable at just above 2 using 3mg of Warfarin daily.

11-19-2010, 01:15 AM
Brand name coumadin is called Coumadin. There's only one.

I'm glad they're at least using a finger prick in the office. The lancets they use in office machines are larger than the home ones. In order to qualify for a home tester you have to have been on coumadin for 3 months.

Have you consulted with a hematologist? Even my first lousy rheumy sent me to one when I got clots. My Mayo AZ doc also sent me to a Mayo one, and my JHU Wegs doc sent me to theirs, too. Hematologists are like Clots R Us. They have particular expertise in understanding how to work with coumadin. Also, they teach you how to adjust it yourself if you're out of range. You don't need to continue seeing them once you're stabilized, though.

11-23-2010, 05:57 PM
I'm in Coumadin since I get W.G. because of DVT but heard that a dose over 8.5 mg is dangerous for bleeding in the brain so you must be careful and consult with hematologist soon

11-24-2010, 12:23 AM
Yes, that's true gmyi. I take 4 mg a day, which allows me to eat all the high vitamin K foods I want. LOTS of green veggies! Doses over 6 mg a day are quite risky. Also, if someone needs a dose that high they're probably not absorbing it well. And if they're not absorbing coumadin, they're not absorbing nutrients from food. It's very important to correct that.