NHS Advice on Warfarin isn't that far away from other worldwide advice, however, elements of it are not correct.
Particularly: "If you miss a dose, just skip it and take the next one as usual".
What a load of rubbish. If you do this you are guaranteeing yourself a dive in INR. I say instead "If you miss a dose, take it next morning." If you've already got around to the next day's dose, just take 150% of usual dose instead. At least this way you're attempting to stop the trend and get on top of it.
In addition the dosing algorithms are too general and not specific enough. I believe you can get on top of a high/low problem by looking at trend, history, and working out what makes sense. This of course requires regular testing, and the algorithms all assume you're tested very rarely indeed.
In summary: A decision cannot be correctly made on a single test snapshot, you require a number of test results to spot trends and patterns.
Particularly: "If you miss a dose, just skip it and take the next one as usual".
What a load of rubbish. If you do this you are guaranteeing yourself a dive in INR. I say instead "If you miss a dose, take it next morning." If you've already got around to the next day's dose, just take 150% of usual dose instead. At least this way you're attempting to stop the trend and get on top of it.
In addition the dosing algorithms are too general and not specific enough. I believe you can get on top of a high/low problem by looking at trend, history, and working out what makes sense. This of course requires regular testing, and the algorithms all assume you're tested very rarely indeed.
In summary: A decision cannot be correctly made on a single test snapshot, you require a number of test results to spot trends and patterns.
Well basic rule of thumb is this: taking warfarin will increase your inr, and not taking it will decrease your inr - so logically what you said makes sense. However, there's diet involved too, and the amount of warfarin a person is prescribed is a VERY SERIOUS concern. If you're taking a large dosage of warfarin to offset your diet of 100 mcg of vit k, then taking a double dosage could lead to bleeding. That's why the advice says to skip it. The advice won't work for everyone, but it's a safe bet.
ReplyDeleteThe best thing someone could possibly do is to learn how the inr changes based on dosage, diet, exercise, sunlight, genetics and etc. That way with that awareness, they can better take measures that will ensure their well being in the case of a mistake on their part.