This raises your INR level. The INR goal for people who take warfarin is usually from 2 to 3. A value higher than 3. Many things can affect the way warfarin works. Some natural health products and other medicines can make warfarin work too well. That can raise the risk of bleeding. If you drink a lot of alcohol, that may raise your INR. And severe diarrhea or vomiting can also raise your INR. The best way to lower your INR will depend on several things.
In some cases, the doctor may have you stop taking warfarin for a few days. You may also be given other medicines to take. You will need to be tested often to make sure your INR level is going down. You will also need to watch for signs of bleeding. The doctor has checked you carefully, but problems can develop later. If you notice any problems or new symptoms, get medical treatment right away. Follow-up care is a key part of your treatment and safety.
The INR test helps balance the risk of internal bleeding against the risk of blood clotting. No special preparation is needed.
However, many medicines, foods and illnesses can affect this test. So tell your doctor about any medicines and supplements you are taking, as well as any changes in your diet. When you are having warfarin treatment, your doctor will probably have a target INR for you. If your INR is too high, it might mean your blood clots too slowly, and there is a risk of bleeding.
If your INR is too low, it might mean you have a risk of developing a blood clot. If you are not having warfarin treatment and your INR is higher than normal, you might need further tests. You can also read more about blood tests in general. Visit our Guide to blood testing to learn more about blood tests in general with information such as:.
Learn more here about the development and quality assurance of healthdirect content. Describes how the prothrombin time PT test is used, why the PT test is done, and what the results might mean.
Read more on HealthEngine website. Description of factors involved in coagulation of the blood, factors measured in the investigation of clotting disorders. Why do we monitor the INR? How often do we measure the INR? What can interfere with the INR? What should my INR be? How is INR tested? Laboratory testing Testing using a portable device Health facility monitoring with a portable device Home monitoring with a portable device Self-testing with a portable device Introduction to blood clotting Coagulation or blood clotting is a protective mechanism of the body against bleeding.
For more information, see Blood Function and Composition. For more information, see Anticoagulants. What is the INR? Regular monitoring is important with a drug such as warfarin because: There is a very small difference between the lowest dose that gives a good effect and the highest dose before side effects which may be serious are experienced; The doses used by different individuals to achieve the same effect can be highly variable; Several drugs interact with the medication to either increase or decrease its effectiveness; and What a person eats can also affect the action of warfarin and either increase or decrease its effectiveness.
Therefore, you should consult your doctor if you: Have a sudden change of diet leafy greens in particular ; Are taking diet supplementation; Are unwell; or Are taking other medications, including over-the-counter medications.
Common medications that interfere with warfarin include: Many antibiotics ; Some heart medications, such as amiodarone e. Aratac , Cardinorm , diltiazem e.
Cardizem , Diltahexal and propranolol e. Deralin , Inderal ; Some anti- cholesterol medications, such as simvastatin e.
Lipex , Zocor ; Some pain relievers and anti-inflammatories, such as celecoxib Celebrex and tramadol e. Tramal , Zydol ; Some antidepressants , such as citalopram e.
Cipramil and sertraline Zoloft ; and Some antiepileptics , such as carbamazepine e. Laboratory testing Laboratory blood testing is the traditional practice in Australia. Testing using a portable device Portable devices, introduced in the s, allow you, your doctor or another health practitioner e. Health facility monitoring with a portable device If the device is used for monitoring in a health facility, a health practitioner often a nurse conducts the blood test and records the result on your behalf.
Home monitoring with a portable device When a portable device is used for home monitoring, you usually conduct the test yourself. Self-testing with a portable device If you self-test, there are two options available: Self-monitoring: which involves your testing your INR at home, and then phoning a clinic with the result and to find if there is a need to adjust the dose and if so what the dose adjustment is; or Self-management: which involves you testing your INR at home, and adjusting your oral anticoagulant dose based on the result obtained, according to a pre-determined dose INR schedule.
More information For more information on coagulation, including information on anticoagulants, blood coagulation tests and test devices, see Blood Clotting and Monitoring.
References Tripodi A. Prothrombin time international normalized ratio monitoring by self-testing. Curr Opin Hematol. A critical evaluation of the prothrombin time for monitoring oral anticoagulant therapy. Pathophysiol Haemost Thromb. Self-monitoring and self-management of oral anticoagulation. Cochrane Database Syst Rev. Antithrombotic drugs: Part I. Optimal oral anticoagulant therapy in patients with mechanical heart valves. This article is for informational purposes only and should not be taken as medical advice.
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