Costs that are covered by health insurance
The health insurance pays the so-called coagulation self-management under certain conditions. The blood-thinning medication must usually be taken for life. The main indication is the presence of an artificial heart valve, which makes permanent blood thinning necessary.
For other diseases, such as atrial fibrillation, other factors must apply in order to obtain approval for self-measurement. Such factors are, for example, the occurrence of complications with the previous INR setting or difficulties of the patient to visit the doctor’s office regularly due to the need for care or a long way to the doctor’s office. Even if permanent blood thinning in children is necessary, an INR measurement device can be approved by the health insurance company. However, the requirements are always assessed individually by the health insurance company.
Causes for a low INR value
The causes of INR values that are too low under therapy with a blood thinner such as Falithrom are mainly incorrect nutrition and interactions with other drugs. The drug Marcumar® is one of the vitamin K antagonists, i.e. it inhibits the effect of vitamin K. However, some components of the blood clotting system need vitamin K to function. If not enough vitamin K is available, the bleeding time is prolonged.
If, for example, a lot of vitamin K is supplied with food, this has the opposite effect. Blood clotting is brought back into action. Therefore patients taking Marcumar® should know approximately, in which food particularly much Vitamin K is contained and these only in measures to consume. Some types of cabbage and spinach are among the foods containing vitamin K. But there are also numerous medicines which can weaken the effect of Marcumar® and thus lower the INR value. These include for example cortisone, digitoxin and digoxin, St. John’s wort, metformin and haloperidol.
INR target values for certain diseases
How high the INR must be depends on the disease that requires blood thinning. The table below shows the most important INR target values. For some indications, such as the mechanical aortic valve, the INR target value depends on other risk factors.
For example, atrial fibrillation is one of the risk factors. If atrial fibrillation is also present, the INR for a mechanical aortic valve should be between 2.5 and 3.5.
- Disease
- INR target value
- Atrial fibrillation
- 2-3
- Thrombosis
- 2-3
- Pulmonary Embolism
- 2-3
- Mechanical aortic valve
- 2-3 or 2.5-3.5 (see text)
- Mechanical mitral valve
- 2,5-3,5
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