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Coumadin Dosage

Monitoring Your Coumadin Dosage

Careful monitoring is essential while taking Coumadin. Even people who have been on a steady dose of Coumadin for years require frequent monitoring. This is done using a blood test known as a prothrombin time (also known as a "protime" PT) or international normalized ratio (INR). The INR is actually just a standardization of the PT test that accounts for laboratory variations. This monitoring will be done daily when you first start Coumadin until you reach a stable and appropriate INR. Thereafter, INR monitoring is done periodically, usually every one to four weeks and more often when necessary.
Although your healthcare provider may choose to monitor your Coumadin dose, he or she will often suggest having a "Coumadin clinic" manage your monitoring and dosage. These are clinics run by specially trained pharmacists (or sometimes nurse practitioners) who specialize in monitoring and dosing for this drug.

Coumadin Dosing Adjustments

Several factors may cause your Coumadin dosage to be changed. Often, starting or stopping another medication (or even just changing the dose) can affect the dosing requirements, since many medications interact with Coumadin (see Coumadin Drug Interactions). Changes in the diet can also affect the dosing requirements (see Coumadin Diet). Sometimes, there is no apparent reason for the change, which is why frequent monitoring is necessary, even for people stable with a dose.
Please be honest and accurate with your healthcare provider about any Coumadin doses you have missed or any dietary changes that have occurred. Your healthcare provider will adjust your dosage based on the information you provide, and providing inaccurate information may lead to a dangerous overdosing or underdosing.
Since dosing for Coumadin can be complicated, many people find it useful to keep track of the amount using a calendar. This is especially useful for people who do not take the same dosage every day, such as one dose on certain days of the week and a different amount on other days.
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Coumadin Medication Information

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