![]() ![]() If you are taking anticoagulant medication, you should visit your doctor immediately to reduce the dose or suppress it completely. If you are not on anticoagulant therapy, values are very high and it may be due to a liver disease that requires immediate attention. There also many drugs (antibiotics for example) that may interfere the effect of anticoagulants. In addition, it may prescribe you small doses of vitamin K. If you are taking anticoagulant medication, you should reduce the dose or stop it according to your doctor prescription to avoid prolonged bleeding. Marked INR increase (4.5 - 7 in adults):. ![]() In people not on anticoagulant therapy, it may be due to a liver disease or disseminated intravascular coagulation ( DIC). If you are taking anticoagulant drugs (warfarin) you should visit your doctor to adjust (reduce) the dose and avoid an INR over 3 (or 3.5 if you have a mechanical heart valve). Moderate INR increase (3 - 4.5 in adults):.Therefore, these values are considered to in the appropriate range. In patients under anticoagulant treatment, those who are being treated with warfarin (Coumadin) or acenocoumarol, the INR should be 2 to 3. INR is only recommended for patients under anticoagulant therapy. Anyway, it is better to use prothrombin time (PT) for this matter. It may be due to a liver disease or vitamin K deficiency. These values in people not under anticoagulant treatment are over the normal range and a visit to your doctor is recommended. In people under anticoagulant therapy with warfarin (Coumadin) or acenocoumarol, values of INR over 3 mean that the dose of anticoagulants prescribed is excessive and should be reduced. In healthy people not under anticoagulant therapy, a high INR value may suggest a liver disease, vitamin K deficiency or disseminated intravascular coagulation ( DIC). The objective of anticoagulant therapy is to prevent cardiovascular disorders and thrombosis. INR is usually used to monitor the dose of patients under anticoagulant therapy. Usually, laboratory changes thromboplastin and/or equipments used to calculate PT with has a direct impact on prothrombin time, but the INR remains constant even with such changes. The major advantage of the INR system is that it helps alleviate confusion in the interpretation of prothrombin time (PT) results. ![]() PT is one of the most important parameters measured in the coagulation screen section of a blood test. INR is close related to the prothrombin time (PT). When there is a hemorrhage, the clotting process is activated to stop the bleeding. 2, 3 However, the single prospective randomized trial on this topic followed 363 patients for two years and found no difference in complications or time spent in the therapeutic range.A high INR (International Normalized Ratio) value shows an increase in the time necessary to complete the clotting process. Two trials using a before-and-after design (which is still more subject to bias than a prospective randomized trial) found more hemorrhages and recurrent thromboembolia in the usual care group than in the group managed by AMS. Large-scale randomized controlled trials with an appropriate duration of follow-up are lacking. When patients can choose whether to attend an AMS or get usual care, it is possible that more motivated, compliant patients are attracted to the AMS. 1 However, most studies were small, and many were non-randomized. A systematic review of the evidence found some support for AMS and PSM over usual care because of increased patient time in the therapeutic range and fewer bleeding complications. Two alternatives to managing anticoagulation in the primary care office are using anticoagulation management services (AMS) and patient self-monitoring (PSM), which relies on home testing of the INR. ![]()
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