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Re: INR value

From: slaporte <silvy.laporte>
Date: Tue, 21 Oct 2008 17:09:50 +0200

Dear Dominik,
The maximum value I saw after an overdose of warfarin was 62 (it was a
case-report at a thrombosis congress). But generally it is below 20. I
don't know specific reference.

>Khaled Nm schrieb:
>>Dear nmusers,
>>I am looking for a reference for a maximum value for INR, byeond this
>>value the drug toxicity of anticoagulatnt may occur.
>>thanks for any response
>>Do You Yahoo!?
>>Tired of spam? Yahoo! Mail has the best spam protection around
>Dear Abduljalil,
>If only it were as simple as that!
>The major toxicity of anticoagulation is bleeding. However bleeding
>episodes may even occur at normal INR levels (much more factors are
>involved). There is no "secure" level, below which no bleeding occurs,
>but the risk of bleeding gradually increases when the INR increases.
>The risk of bleeding we are willing to accept (i.e. the maximum INR value)=
>is given by the probability and seriousness of expected thromboembolic
>events (risk benefit ratio). Therefore target INR values are fixed
>dependent on the underlying disease: E.g. venous thromboembolic disease:
>2.5, artificial heart valves: 2.5-3, thrombophilia: 3.
>With respect to non-bleeding toxicity of coumarins: these are largely
>dose independent.
>Regards Dominik
>Prof. Dr. med. Dominik Uehlinger
>Klinik und Poliklinik für Nephrologie und Hypertonie
>Universität Bern, 3010 Bern - Inselspital
>Tel. +41 31 632 31 44, Fax +41 31 632 97 34
Received on Tue Oct 21 2008 - 11:09:50 EDT

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