What Acitrom Dose Adjustment Is Needed To Raise My Elderly Father S INR Level After MVR With A Tissue Valve?

Hello, First, the anticoagulation scheme may vary in someone with a tissue mitral valve, especially if it has been many years since surgery, according to the cardiologist s long-term approach. Some doctors stop long-term Acitrom after a few months; others, however, continue this if there is an additional risk. Since your father is still on Acitrom, it would mean that his cardiologist wants his blood to remain within a certain clot-preventing range. I am unable to tell you the specific Acitrom dose to raise the INR, because this medication acts unpredictably in elderly individuals. The same dose change will overly elevate INR in some people, while in others it will barely budge it. Acitrom adjustments must always be made under the supervision of a physician because sudden elevations may lead to dangerous bleeding. What can be said with surety is that: 1. Your INR level is only mildly low. Hence, the next step is a small supervised adjustment, with no substantial change. 2. Elderly patients are sensitive to Acitrom; even a small increase may abruptly elevate INR above 3.5. 3. The cardiologist will want to repeat the INR in 3 to 5 days after any dose change. 4. Please, do not change the dose yourself, especially since he is 75 years and taking other medicines that might interact. At my clinic, when anyone on Acitrom presents with INR 1.6, I quickly ask a few questions before making any adjustments: • Any missed doses in the past 1 to 2 weeks? • Any dietary changes recently, such as increasing green leafy vegetables? • Any antibiotics, pain killers, or new medicines started recently? • Any bruising, black stools, gum bleeding, or weakness? These small things often explain mild INR changes. The safest and most honest advice, therefore, is to get his prescribing cardiologist or family physician to adjust the dose and repeat INR in a few days. Without examining him and reviewing all factors, it would not be safe to adjust it. You are doing the right thing by monitoring this closely. Just get a quick review from his doctor, and the INR will usually settle into the target range with a tiny supervised change. Take care. Hope I have answered your question. If you have any further query I will be happy to help. Wish you good health. Regards, Dr. Usaid Yousuf, General and Family Physician