kcnurse2003 replied: "My question back to you first would be:
Are you talking about your actual "protime" or the INR (International Normalized Ratio)? The INR is the standard laboratory value that clinicians, like myself, would monitor to manage and adjust your coumadin/warfarin dose.
If you are talking about the INR, consistency is the KEY to maintaining a therapeutic target range. With that said, the use of generic warfarin sodium can make an INR level fluctuate, even if nothing else does. For example, if you have not had any changes in diet, medications (over the counter or prescription) and general health issues, the use of a generic drug could be the issue.
I attended a seminar presented by Dr. Moe (Medical Director and cardiologist) and he stated that the FDA allows a 25% variance of a generic drug from it's original dose. For example:
warfarin Sodium dosage 1mg
Depending on the manufacturer...
Dose could actually be 0.75mg up to 1.25mg
A slight change like this can reek havoc on the INR result over the course of a year. Most patients want to utilize generic drugs due to the high cost associated with Coumadin and or their insurance formulary suggests it.
A patient should not only look at the cost of the medication as a deciding factor but the ancillary costs related to travel/gas cost, inconvenience of poor parking, bad weather, waiting room/lab time, and not to mention more frequent testing due to unstable INR results causing multiple medication adjustments.
for more information on topics related to anticoagulation visit my website at"
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