Brief Answer: Medicine adjustments... Detailed Answer: Hi, INR level is strongly affected by drug levels of anticoagulants. Some food and certain medications interfere and interact with absorption and drug metabolism, thereby affecting the INR levels. I do not see any such drugs or food mentioned by you here. If you are not aware of it 1. Green leafy vegetables including spinach, brocolli, cranberries, green turnips, brussel sprouts, green mustards, mushroom and so on. Among non vegetarian diet liver interfere with coumidin functions. 2. Drugs like Vitamin K, some antibiotics, birth control pills (if you are a female), steroid in any form, beta blockers, lipid lowering drugs (statins) and so on interfere with coumadin effects. If you feel any drug or the food isn't interfering with coumadin, then the only way to boost INR values is by adjusting coumadin levels. I would gradually hike coumadin by 1mg if INR value is lower than the desired levels at 3rd week. Follow up with your treating doctor. Hope this helps. Let me know if you need clarifications. Regards

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Brief Answer: Medicine adjustment are deemed necessary... Detailed Answer: Hi, I assume lipid lowering drugs are prescribed in view of risk factors. If you are on strict non vitamin K diet and no other interfering drugs, the best approach is to follow up patiently with your treating doctor. Enoxaparin (levonox) injection has been prescribed to you as a supportive drug; to prevent any clot formation as coumadin takes time to stabilize. So you are still protected against clot formation even when INR value is lower than the desired level. Needless to say, it will be taken off as INR value reaches the desired level. In this instance, my suggestion to you is simple; take your medicines (coumadin) at regular intervals religiously. If I were to be your treating doctor, I would order INR check once every 3 days and accordingly increase the dose further - 5mg and 7.5mg on alternate days. Please discuss with your treating doctor. Hope this helps. Regards

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