help, coumadin alternating dose

[micstn]

Can someone kindly explain order " 1 tab x 4 days alternates with half tab x 3 days " on coumadine?

Does this mean patient need to take 1 tab on mon, wed, fri, son and half tab on tue, thu, sat? Or 1 tab from mon through thursday and half tab from friday through sonday?

Thanks a lot!

[tnbutterfly - Mary, BSN]

Most likely it means 1 tablet Mon, Weds, Fri, Sun and 1/2 tablet Tues, Thurs, Sat.

Thread moved to Nursing and Patient Medications for more response.

[micstn]

Thanks, that's what I thought too

[fsh1986]

PP's answer is what I would go with as that's how I've seen coumadin ordered, alternating doses/days BUT I would call the MD and clarify.

[Elladora]

Most of our clients are on alternating Coumadin and it's as you thought - one dose on M, W, F, Su and another on Tu, Th, Sa. If in doubt, call the prescribing doctor for clarification.

[Meriwhen, ASN, BSN, MSN, RN]

It's not uncommon to see patients on alternating warfarin doses. I've even seen patients on every other day/every 2nd day dosing (e.g., take on Mon, skip Tue, take on Wed, skip Thurs, etc.).

I'd agree with the other posters' interpretation of the dosing schedule, but I would clarify with the MD just to be sure, especially since you'd be giving two 1-tablet doses back-to-back (Sun and Mon). They may want that, they may not, or maybe they're planning to draw a new PT/INR every week after day 7 and tweak the dosages accordingly.

[morte, LPN, LVN]

there should be, as part of the order, the next PT/INR. If nothing else, question doc on that.

It's not uncommon to see patients on alternating warfarin doses. I've even seen patients on every other day/every 2nd day dosing (e.g., take on Mon, skip Tue, take on Wed, skip Thurs, etc.).

I'd agree with the other posters' interpretation of the dosing schedule, but I would clarify with the MD just to be sure, especially since you'd be giving two 1-tablet doses back-to-back (Sun and Mon). They may want that, they may not, or maybe they're planning to draw a new PT/INR every week after day 7 and tweak the dosages accordingly.

[jadelpn, LPN, EMT-B]

I would most definetely clarify the order "5mg on Mon, Wed, Fri, Sun and 2.5 mg on Tues, Thur, Sat..." or whatever it is that you are to give. One tab could be any strength. Also, I agree with the INR statement as noted above, as usually they are needed at least weekly if patient is theraputic. (which you should also have a theraputic range goal as well).