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ELEVATED INR

Elevated INR

WHAT YOU NEED TO KNOW:

What is an elevated INR? The INR, or International Normalized Ratio, is a measure of how long it takes your blood to clot. A prothrombin time (PT) is a another blood test done to help measure your INR. The higher your PT or INR, the longer your blood takes to clot. An elevated PT or INR means your blood is taking longer to clot than your healthcare provider believes is healthy for you. When your PT or INR is too high, you have an increased risk of bleeding.

What increases my risk for an elevated INR?

  • Too much anticoagulant medicine, a type of blood thinner that helps prevent clots

  • Other medicines, such as aspirin, NSAIDs, and some antibiotics, when you also are using anticoagulants

  • Health conditions, such as liver failure or bleeding disorders

  • A sudden decrease of vitamin K in your diet

What are the signs and symptoms of an elevated INR? You may have small cuts that bleed more than normal, and for longer than normal. You may bruise easily, have frequent nosebleeds, or notice your gums bleeding.

How is an elevated INR treated? Treatment depends on whether you currently have bleeding and how severe it is. If you take an anticoagulant medicine, your healthcare provider may change your dose, or tell you to skip one or more doses. You may need one of the following treatments:

  • Vitamin K may be given to decrease your INR and bleeding.

  • Blood components may be given during a transfusion to help stop your bleeding. Blood components are the parts of blood that help it to clot. Examples are clotting factors, platelets, and plasma.

How can I prevent an elevated INR?

  • Have your INR measured regularly. Your healthcare provider may want your INR to be measured every few days until it is stable, and then only once a month. You may have blood drawn at your healthcare provider's office. Some people can test their blood at home.

  • If you take medicine, take it as directed. Contact your healthcare provider before you take other medicines or supplements, because they may elevate your INR.

  • Eat the same amount of vitamin K daily to keep your INR stable. Vitamin K changes how your blood clots and affects your INR. Vitamin K is found in green leafy vegetables, broccoli, grapes, and other foods. Ask your healthcare provider for more information about what to eat when you have an elevated INR.

  • Limit alcohol. Alcohol increases your INR. Ask your healthcare provider how much alcohol is safe for you.

  • Do not smoke. If you smoke, it is never too late to quit. Smoking can affect the way your blood clots. Ask for information if you need help quitting.

How can I decrease my risk of bleeding?

  • Avoid activities that may cause bleeding or bruising.

  • Brush and shave gently. Use a soft toothbrush and an electric razor to avoid bleeding.

  • Tell your dentist and other healthcare providers if you take anticoagulant medicine or have a bleeding disorder. Wear medical alert jewelry, or carry a card that gives this information. Ask where you can get these items.

When should I contact my healthcare provider?

  • Your menstrual period is heavier than normal.

  • You see blood in your urine.

  • Your bowel movement is bloody or black.

  • You bruise or bleed more than normal, your gums bleed, or you have frequent nosebleeds.

  • You have pain or swelling in your joints.

  • Your fingers or toes turn dark purple.

  • You have more headaches than normal, or your headaches are different than before.

  • You have questions or concerns about your care.

When should I seek immediate care or call 911?

  • You throw up blood, or your vomit looks like coffee grounds.

  • You have any kind of bleeding that does not stop in 15 minutes.

  • Your leg feels warm, tender, and painful. It may look swollen and red.

  • You have any of the following signs of a stroke:
    • Numbness or drooping on one side of your face

    • Weakness in an arm or leg

    • Confusion or difficulty speaking

    • Dizziness, a severe headache, or vision loss

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.