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What Cause Increase In INR Level?

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Posted on Mon, 21 Apr 2014
Question: please help, my husband has been taking wafarine 4 the last 8 yrs. his ideal range is 2.5 & this has been ok up until this weeks testing when it jumped to 3.2. he has 1pt of cider in the evening, that's all the alcohol he has but, in the last week he has been having 3rashers of fried bacon, fried bread, &fried egg daily at breakfast. Also in the evening he has been having cream crackers +butter &blue cheese. he has also been eating lots of oranges, maybe 5/6 daily. is any of this the cause of his warfarin level gone haywire. we know all about vitamin k so it's not that.we need to get it back on track. thank you, XXXX
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Answered by Dr. Chobufo Ditah (7 hours later)
Brief Answer: Monitor again next week for any changes! Detailed Answer: Hi and thank you so much for this query. I am so sorry to hear about this increased in INR number and all the inconveniences this has caused you. I have taken a look at his diet and seem not to find any reasons to suggest that his diet may be responsible for this. Unless something beyond oranges has changed in his diet recently, I will not think this is the cause. Monitoring is very important to know if we are in the normal range or not. Changes can always be made to make sure we stay true to the treatment goals. I will suggest that we control this number in a weeks time to see if this was just a one time out of range value or a permanent increase. Should it be a permanent increase, then adjusting the dose of his warfarin to bring it back to the normal range would be encouraged over manipulating his diet that seems more complex than a single drug. Even if his diet were responsible for this, I will rather choose to reduce the dose of warfarin to accommodate this rather than the other way round. Also, the dose of warfarin needed to maintain the target range can change over time. Having been on it for 8years, it would be very difficult to have the same dose all along without needing adjustments at some point. For now, I will like him to understand that he is at increased risk of bleeding and should keep away from any activities that may lead to bleeding or cause him to sustain a cut. Should he have an active bleeding, he should go to the hospital for immediate attention. In all, let's control this value in a weeks time. For now, let him play safe avoiding every possible cause of bleeding or sustaining a cut. We would take from there depending on the results of this control test. I hope this helps. I wish you both well. Thanks for using our services and do feel free to contact e for more information and clarification if need be. Dr. Ditah, MD.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Chobufo Ditah (2 hours later)
Dear Dr Ditah . thank you for your very informative reply. my husband has got to go back to have a futher I.N.R. done on Friday April 4th. hopefully as you state this could be just a blip we hope so. thank you again for your time &concern.
doctor
Answered by Dr. Chobufo Ditah (14 hours later)
Brief Answer: THanks and keep me updated! Detailed Answer: Hi and thanks for providing me with this information. I will be happy to know what the control value gets to be. Please, keep me updated. I wish you both well. Dr. Ditah, MD.
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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Chobufo Ditah

General & Family Physician

Practicing since :2009

Answered : 6323 Questions

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What Cause Increase In INR Level?

Brief Answer: Monitor again next week for any changes! Detailed Answer: Hi and thank you so much for this query. I am so sorry to hear about this increased in INR number and all the inconveniences this has caused you. I have taken a look at his diet and seem not to find any reasons to suggest that his diet may be responsible for this. Unless something beyond oranges has changed in his diet recently, I will not think this is the cause. Monitoring is very important to know if we are in the normal range or not. Changes can always be made to make sure we stay true to the treatment goals. I will suggest that we control this number in a weeks time to see if this was just a one time out of range value or a permanent increase. Should it be a permanent increase, then adjusting the dose of his warfarin to bring it back to the normal range would be encouraged over manipulating his diet that seems more complex than a single drug. Even if his diet were responsible for this, I will rather choose to reduce the dose of warfarin to accommodate this rather than the other way round. Also, the dose of warfarin needed to maintain the target range can change over time. Having been on it for 8years, it would be very difficult to have the same dose all along without needing adjustments at some point. For now, I will like him to understand that he is at increased risk of bleeding and should keep away from any activities that may lead to bleeding or cause him to sustain a cut. Should he have an active bleeding, he should go to the hospital for immediate attention. In all, let's control this value in a weeks time. For now, let him play safe avoiding every possible cause of bleeding or sustaining a cut. We would take from there depending on the results of this control test. I hope this helps. I wish you both well. Thanks for using our services and do feel free to contact e for more information and clarification if need be. Dr. Ditah, MD.