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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Low INR Levels Despite Taking Coumadin

I have some type of blood clotting disorder and my INR on Fri was 1.1 and after taking a dose of 7.5 of coumidin (my usual daily dose id 5 mgs) it only went up to 1.3 on Monday. My level has never been that low. 2 wks ago I was in the hospital with blood loss and was given 5 bags of blood but my hemaglobin level rose very slowly. I was told that I have an enlarged liver when i had a procedure when I was hospitalized the wk before with mild pancreatitus and sludge in the duct. I still have pain on my LUQ and shooting to my side and back. THe Gastro wants to do a test to see what is going on with my liver. Do you have any suggestions or ideas of what may be going on? Thank you. Suzie Dickson
Thu, 11 Jan 2018
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Hematologist,  's  Response
While your INR is a reflection of how well your coumadin is acting, there may be a host of factors that can lead to a sub-optimal INR (<2). The most common of these is an interaction of other drugs that you may be taking. These may lower the effect/drug-level of coumadin. Also do not change your diet drastically (e.g. consuming a lot of green leafy vegetables) all of a sudden. In case you have a sub-optimal INR, you will need escalation of the coumadin dose and close monitoring by a hematologist with Weekly to twice weekly INR level monitoring.
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Suggest Treatment For Low INR Levels Despite Taking Coumadin

While your INR is a reflection of how well your coumadin is acting, there may be a host of factors that can lead to a sub-optimal INR ( 2). The most common of these is an interaction of other drugs that you may be taking. These may lower the effect/drug-level of coumadin. Also do not change your diet drastically (e.g. consuming a lot of green leafy vegetables) all of a sudden. In case you have a sub-optimal INR, you will need escalation of the coumadin dose and close monitoring by a hematologist with Weekly to twice weekly INR level monitoring.