See a doctor immediately. They will have to give you a shot of vitamin K. Is this on a home test? If so take the equipment with you. Also the coumadin you are taking. Are you taking any NSAIDS? If so STOP. If it means you have to go to the ER to see a doctor, then go. You could bleed too easily.
Contact your Dr. 6.5 isnt horribly high. We didnt give Vitamin K until you were over 8.0 but 6.5 still puts you at higher risk for bleeding internally. More than likely your Dr will have you hold doses of coumadin and test again but you need to do so under his orders NOT on your own!! Like Kaismama states, if you got this result on a home monitor, you should take it with you to be sure it is calibrated properly and not giving you a false high reading. They may double check your result with a regular blood draw lab test or they may go ahead and treat you. If you start getting signs of bleeding like bloody or tar-like stools, nosebleeds, abdominal pain, large unexplained bruising, etc. then go to the ER or call 911. This happens on occasion (high INR).
Have you changed anything in your diet? Were you eating more greens then suddenly stopped? Have you taken any OTC pain medications including Tylenol or acetaminophen? Vitamin E? These things can affect the way coumadin works in your body and makes it more potent. Your blood isnt actually "thinner". Coumadin affects clotting factors. It interferes with the way your blood normally clots so if you cut yourself or get an internal bleed, it may not stop and you can hemorrhage. Dont panic yet though. The main thing is to contact your Dr who prescribes your coumadin and let him know your results then follow his directions. It is very important to keep your diet consistant and not take ANYTHING medication (OTC or Rx) without asking your coumadin Dr about it. Sometimes a body just does this for no apparent reason at all. That is why monitoring the INR is so important and why it should be done regularly even when you are fairly stable.
My Father received an LVAD heart pump in December 2013. He was put on Coumadin to make sure his clotting factor remains low enough that he won't develop a clot at the pump.
Lifespan comes to his home twice a week to draw blood, checking his INR - which they like to see at around 2.5. The results are electronically sent to Tufts in Boston, where his Dr. will call to adjust his Coumadin dose if the INR has dropped or risen. Many patients don't maintain a stable INR on Coumadin, which doesn't react as quickly as Heparin (unfortunately this can't be used w/ an LVAD).
He's been hospitalized 3x since October 2014 after his INR has quickly risen to between 5.0 - 6.0. Each time he's had internal bleeding. He's in the hospital right now because of this. His blood draw on Thursday showed his INR at 3.0 so they had him decrease his Coumadin. Sunday morning he was so weak he could barely sit up in bed. The rescue brought him to the hospital, where they said his INR was 5.0. Today, he will receive his 3rd unit of blood. They usually give hime some Vitamin K intravenously as well. It will take days for his INR to get back to a level where they'll release him from the hospital.
From what I read above, it seems that everyone's "tolerance" for internal bleeding based on the INR may be different.
Go to the ER immediately, my level was 3.6 once and the veins were sticking out in my arm it was freaky and scary.
I went to the ER and they said that it's good I came in because it's nothing to wait around for.
Better safe than sorry.
- Coumadin Information for Consumers
- Coumadin Information for Healthcare Professionals (includes dosage details)
- Side Effects of Coumadin (detailed)
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