Living with a Mechanical Heart Valve: Click.Tick.Thump. Love It!

Support Group for Mechanical & Artificial Heart Valve Surgery & Using Warfarin

Low INR Even After High Dosage Coumadin and Lovenox - What Can I Do?

Hey Everyone

My INR has been 1.3, 1.7 and 1.8 in the past 3 weeks (I am now 9 weeks out of surgery). I do not know why it is now so low and wont go up (I am on 15 mg / 10 mg coumadin alternating and also lovenox).

Has anyone had problems with low INR? Are there any options to increase INR? I do not eat any leafy foods, dont eat high vitamin K foods, dont drink alcohol, dont smoke, etc.



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Comment by Richard Deal on December 10, 2010 at 14:19

hey david,

my only suggestion would be to ask about phenprocoumon as an alternative to coumadin - as it is metabolised differently and may just be the "breakthrough" you need. i have never taken warfarin, so I can't help there, but a friend who had a PE after DVT had 3 months of messing around with coumadin before she got relatively settled... so I guess you might still have a way to go!

on pheprocoumon, taking 3mg a day, it took me 2 weeks and 2 heparin injections after the operation to get to my target range, and now i am fairly bomb-proof...

take care,


Comment by Tracie Reynolds on December 8, 2010 at 12:04
my inr has not been stable since my op last dec 09 i have tried everything and its still all over the place my inr should be between 3/4 its either 5.4 or 2.3 i think only once in the past year have i met my range. i know it will get there just a matter of getting the warfrin right. hope yours sorts itself out :)
Comment by Graeme on December 7, 2010 at 10:38

thats pretty dramatic stuff. What is the desired INR range that you have been set? Mine is from 2.8 to 3.2 . Note that everyone is different and your specialist should have given you your target INR range on leaving hospital.

You also are on a fairly hefty dose of coumadin; I take 7.5/8 alternating each day.

David, everyone is very different with their body chemistry and the way it reacts to coumadin (called warfarin here in the UK) and your doctor(s) are going to be the best to work this out with. I do remember however when i first started taking it i had a devil of a job getting my body to get to my desired INR and i was all over the place for the first 6 - 12 weeks or so. I don't think that beefing up your intake of vitamin k is a good idea - i think what you have to do - as most of us have found out - is try to stick to a fairly regular diet that does incorporate a bit of everything ie you DO HAVE fruit and vegetables. There is a good link to a coumadin cookbook on the site off the top line menu under 'Warfarin'.

More than anything else make sure you work this through in close consultation with your doctors and specialists. They are the 'masters of the universe' for this ...




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