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Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 18452
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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I was diagnosed in December 2014 with AF and put on warfarin,

Resolved Question:

I was diagnosed in December 2014 with AF and put on warfarin, I am currently on a daily dose of 3mg, I normally take my 3mg tablet at 10.30 in the evening, I woke this morning and thought I had forgotten to take my last evening dose, so took a 3 milligram tablet this morning then realised I had take my dose last night, my last weekly blood test was Friday 6 January and gave a INR 2.8. I have contacted the 111 service this morning who I feel were kess than helpful in relieving my worry, simply saying I should contact my anticoagulant clinic when open, but that is at 9 am.
Submitted: 2 years ago.
Category: Medical
Expert:  Dr. D. Love replied 2 years ago.
Hello from JustAnswer.

This is not a serious problem, nor an urgent problem, which is why they said that it can wait until the anticoagulant clinic opens, although they apparently did not explain it well.

It takes several days for Coumadin to get into the system (or for the effect to wear off). This is partly because of the duration of the drug, but has more to do with the longevity of the proteins made in the liver affected by the Coumadin. Consequently, if someone doubles the dose of Coumadin every day, it will take about 3 days before we start seeing an effect on the PT/INR.

In the case of someone accidentally taking a single extra dose, we also have plenty of time to adjust the dose on the subsequent days to limit the impact of that extra dose. Depending on your history, they may simply skip the next day's dose or cut it in half. But in either case, there is no urgency to address a single extra dose, and the clinic that is familiar with your history would be the best option to adjust the dose that you are scheduled to take at 10:30 tonight, and that will deal with the accidental extra dose.

There certainly is no risk that you will have any bleeding problems from a single extra dose before you can contact your clinic. So there is no reason for you to be concerned about the immediate situation, and your clinic will be able to compensate for the effect of the extra dose before it would become an issue.

If I can provide any further information, please let me know.
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