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Will Missing Coumidin Have Any Ill Effects?

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Posted on Sun, 24 Jun 2012
Question: If a patient is on 5mg of coumidin and doesn't remember if he took his pill for the day...he's not sure if he lost it or if he took it with his other evening medications. His next INR is for Thursday.
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Answered by Dr. James M. Schwartz (8 minutes later)
Hello,

I am happy to answer your question.

Coumidin levels are reflected about 3 days after a dose. So a missed dose would be expected to cause a decrease in the INR and PT about 3 days from now. However, a single missed dose, couched in long term stability, might not change the INR/PT at all. Add to that the fact that the baseline risk of blood clots (which coumidin prevents) is very low - about 6% per year in the case of atrial fibrillation. So if my patient were to tell me this, I would advise them to not worry about it.

I hope this answers your question. Please feel free to follow up with any additional questions.

Best,
Dr. Schwartz
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Above answer was peer-reviewed by : Dr. Raju A.T
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Dr. James M. Schwartz

General & Family Physician

Practicing since :1992

Answered : 47 Questions

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Will Missing Coumidin Have Any Ill Effects?

Hello,

I am happy to answer your question.

Coumidin levels are reflected about 3 days after a dose. So a missed dose would be expected to cause a decrease in the INR and PT about 3 days from now. However, a single missed dose, couched in long term stability, might not change the INR/PT at all. Add to that the fact that the baseline risk of blood clots (which coumidin prevents) is very low - about 6% per year in the case of atrial fibrillation. So if my patient were to tell me this, I would advise them to not worry about it.

I hope this answers your question. Please feel free to follow up with any additional questions.

Best,
Dr. Schwartz