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Warfarin

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Overview Coumadin is known as a blood thinner or anticoagulant. That means it is prescribed to prevent the formation or recurrence of blood clots. People who experience a pulmonary embolism or thrombophlebitis in their legs often receive warfarin to reduce the risk of more serious complications. When clots are feared, this medicine may lower the likelihood of a heart attack or stroke.

Coumadin works by blocking key factors necessary for normal blood coagulation. Vitamin K plays an important role in this process. Getting the right dose can be a very tricky process. Too little warfarin may not allow for adequate clot protection, but too much could lead to life-threatening hemorrhage. Like Goldilocks and the porridge it may take some experimentation to get things just right. That requires frequent blood tests for prothrombin times, especially in the early phase of treatment.

Side Effects and Interactions Side effects of Coumadin therapy are uncommon if the dose is appropriate and blood tests are carefully monitored. Some people have occasionally reported hair loss, skin rash, itching, nausea, fever, digestive upset, diarrhea, hepatitis, purple toes, red-orange urine, prolonged, painful erections, and mouth ulcers. Report any such symptoms to your physician promptly.

A large number of over-the-counter and prescription medications may interact with Coumadin in a dangerous way. Some drugs, including barbiturates and the anticonvulsant Tegretol (carbamazepine), can reduce the effectiveness of Coumadin and increase the risk of blood clots. Others, such as the antibiotics metronidazole (Flagyl) or co-trimoxazole (Bactrim, Septra, etc.), can increase the blood thinning potential of Coumadin and thereby raise the risk of dangerous bleeding. The drugs Nolvadex (tamoxifen) and Danocrine (danazol) can also increase susceptibility to hemorrhage when a woman is taking Coumadin.

Because aspirin also acts as an anticoagulant, though it works differently from Coumadin, it should be avoided unless your doctor specifically prescribes it and monitors bleeding time. The heart drug Cordarone (amiodarone), the ulcer drug Tagamet (cimetidine), anabolic steroids such as Anadrol-50 (oxymetholone) and antibiotics such as Biaxin (clarithromycin), erythromycin or tetracycline can also make hazardous bleeding more likely for people on Coumadin. Some individuals may also be vulnerable to increased bleeding when they take the antidepressants Paxil (paroxetine), Prozac (fluoxetine) or Zoloft (sertraline). Also beware of quinine derivatives prescribed for the heart.

Patients should be wary of taking thyroid drugs, cholesterol medications and tuberculosis medicines in combination with warfarin. Vitamins E and K could also be problematic. Consult with the prescribing physician before making any changes in the regimen.

Coenzyme Q10 may counteract the benefits of warfarin. Anticoagulants such as Coumadin may pose a hazard when taken with the herb ginkgo biloba. An elderly woman on Coumadin had a hemorrhagic stroke after two months of ginkgo. If the extract of the herb hawthorn is taken together with Coumadin, careful monitoring of bleeding time (through PT and INR) is essential. The anticlotting action of the herb horse chestnut (aesculin) may interact with Coumadin to increase the risk of bleeding. This combination should be avoided.

It is possible that juniper berries may interact with Coumadin to increase the risk of bleeding. This possibility remains hypothetical. Licorice binds to serum albumin and may interact with Coumadin. The coumarins in licorice may also potentiate the action of Coumadin, possibly leading to unexpected bleeding. Despite research suggesting that ginseng might reduce platelet aggregation, the only reported interaction with Coumadin resulted in a decreased INR (international normalized ratio, a measure of blood clotting propensity). This suggests that ginseng might possibly counteract the benefit of warfarin. A red clover extract containing coumarin derivatives might in theory interact with the anticoagulant Coumadin. Close monitoring of prothrombin time or INR is advisable.

Psyllium can affect the absorption of Coumadin. To avoid this, psyllium should be taken at least an hour after Coumadin. In theory, garlic could increase the risk of bleeding in people taking anticoagulants such as Coumadin. The herb pau d'arco causes vitamin K-reversible bleeding, strongly suggesting that it would interact with Coumadin to increase the danger of hemorrhage. The anticoagulant activity of astragalus may interact with that of warfarin, increasing the risk of bleeding. This herb capsicum (cayenne) may have the potential to prolong clotting time, so people taking Coumadin should exercise caution before eating quantities of chili peppers. Cayenne also inhibits liver enzymes (CYP1A2) and thus could potentially slow the metabolism of warfarin.

In theory the coumarins in the herb chamomile might potentiate Coumadin's effect. Careful monitoring of bleeding time (through PT and INR) are recommended if chamomile is to be used together with Coumadin. One woman was hospitalized with internal bleeding after consuming chamomile tea regularly while taking Coumadin. (CMAJ, Apr. 25, 2006) Also in theory, the herb feverfew could increase the risk of bleeding in people taking Coumadin. Because ginger inhibits prostaglandin synthesis and reduces platelet aggregation, caution should be exercised in combining it with warfarin. The combination could result in unexpected bleeding. It is not known whether the coumarins in the herb dong quai might interact with Coumadin. To be safe, any woman taking both dong quai and Coumadin should discuss this situation with her doctor and should have bleeding time (PT and INR) checked frequently, especially when starting or stopping the herb. Goldenseal reportedly limits the effectiveness of the Coumadin. As a general rule, do not take any other medication or herbs without first checking with your physician and pharmacist.

Taking the Medicine Although the absorption of Coumadin may be slightly slowed by food, the medicine can be taken at meal time, especially if it upsets your stomach. There are, however, certain foods that may reduce the effectiveness of this drug. Because Vitamin K can counteract the action of warfarin, it is important to get approximately the same amount of this vitamin every day. Be careful not to overdo suddenly on foods that are rich in this nutrient. These include broccoli, cabbage, spinach, collard greens, kale, brussels sprouts and lettuce. This doesn't mean that you must avoid such healthy vegetables, but don't suddenly increase your intake without careful monitoring of prothrombin time. (For a more complete list, see our Guide to Coumadin Interactions.) The same warning would hold if you suddenly dropped one of these from your diet completely.

Special Precautions Anyone taking Coumadin must monitor his body carefully. Be alert for any early warning signs of bleeding. Symptoms to watch for include bruising or red spots under the skin, red or dark urine, red, black or tarry stools, nosebleeds, or bleeding around the gums after gentle tooth brushing. Internal hemorrhaging may manifest itself in a variety of ways, including pain in joints, chest, stomach or head. Shortness of breath, difficulty breathing or unexplained swelling could indicate bleeding. Alert your physician immediately if you notice any unusual symptoms or signs of spontaneous bleeding.

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115 Comments

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Quinine has been prescribed by my Dr., and also thyroid. No one has ever told me this is not good for me and I am on warfarin.

I am scheduled to fly to Brazil from Miami. I have been on coumadin for many months. Is this dangerous? We will be visiting for six days at the headquarters but will be visiting remote mission stations for the last three days. We will only be in Brazil for ten days. My daughter is an MD and suggested I should think twice about going.

Turmeric increases the effect of coumadin. I have been on coumadin for 15 years because of an artificial aortic valve.

I read that turmeric was effective in lowering cholesterol. I began sprinkling it on broccoli. My INR went up dramatically. My Pharmacy PHD said "STOP."

Has anyone done any studies on the effect of turmeric? Could it replace coumadin?

Enjoy your program.

Thanks,

CCH

PEOPLE'S PHARMACY ANSWER:

You are not the first person to report this interaction between Coumadin (warfarin) and turmeric. This is a dangerous combination and others have reported a spike in their INR lab values (a measure of blood clotting time). Our fear is that this could lead to a serious bleeding episode!
In our opinion, turmeric (and its active component curcumin) should not be combined with Coumadin!

Is there a negative reaction between coumadin and cranberry juice? If so, what kind can I expect?

PEOPLE'S PHARMACY RESPONSE: UK AUTHORITIES HAVE REPORTED SEVERAL CASES OF BLEEDING PRECIPITATED BY CRANBERRY JUICE ADDED TO COUMADIN.

I'm just beginning to take coumadin. I have used psyllium husks for years since I take so many other medicines that tend to cause constipation. Can I keep taking it in the morning and take the coumadin at night?

Thank you for your article on cinnamon and coumadin. It was in Bflo. News about 2 yrs. ago -- I always have oatmeal for breakfast and add cinnamon. We went to Europe in 2006 and ate totally different foods for breakfast and had no cinnamon for a little over 2 weeks. Had a PT test when I came home and was told the result of the test was as if I wasn't taking coumadin at all. I showed your article to my doctor to see what he thought -- he said continue using cinnamon but use the same amount each day. Thank you so much -- your article was perfect timing. Until I read your article I had no idea that cinnamon was an anticoagulant!

I have experienced (multiple times) a blood thinning effect from Thai food containing cayenne peppers, turmeric and ginger. This seems to really cause a spike my PT/INR. The question I have is how much do the root plants such as garlic, wild leeks, certain onions effect warfarin/coumiden? I think I have noticed such an effect from wild leeks (ramps).

My mother is 87 years old and is on coumadin plus other medicines. She often says that she misses the food that she most enjoys: broccoli, cabbage, romaine lettuce, brussel sprouts, blueberries, cranberry juice, licorice, onions, chili, celery, pickles, margarine and sauerkraut. Since being given a change in her diet, she has increased eating food rich in sugar, meats, and fats, and now diagnosed with diabetes.
She wants to be medicine free and wonders if gradually there is any way that she can introduce any of the foods that increase blood thinning, while possibly decreasing her coumadin.

Is it okay to have 3-4 beers in the evening if taking coumadin? My husband takes 12mg. a day for a blood condition. He claims it is okay to drink a few beers a week and smoke one cigar a month. He is 62 years old. Has worked out at a gym for over 40 years, 3-4 times a week. He is in good health for his age except for this rare factor 5 laden blood disease which recently surfaced in his body.

Thank you.

PS I just discovered your site on NBC this morning. I will use it frequently. Lots of good information.

PEOPLE'S PHARMACY RESPONSE: A FEW BEERS A WEEK (2 OR 3) MIGHT BE OKAY. THREE OR FOUR MOST NIGHTS PROBABLY ARE NOT. ALCOHOL HAS AN IMPACT ON HOW THE BODY HANDLES COUMADIN.

I take coumadin and I was told not to eat guacamole, and that it would cause me to have a reaction. Is this true?

PEOPLE'S PHARMACY RESPONSE: AVOCADOS DON'T HAVE MUCH VITAMIN K, BUT THEY CAN INTERFERE WITH COUMADIN EFFECTIVENESS. (LANCET, 1991)

I have just completed prostate cancer treatment and am now impotent. I am taking Coumadin. Is it safe to take Viagara with Coumadin?

I've been taking Warfarin for about three weeks. I suffer from constant dry mouth and lips and a sore throat. I have very painful mouth sores on my tongue and lips. I called my doctor and he said mouth sores don't have anything to do with taking Warfarin. But I see information online that says I should contact my doctor if I'm experiencing them. Does anyone have any insight about this? Any suggestions to help alleviate the discomfort?

Been on coumadin (5 mg) for 2 years and was told, of course, to never take aspirin again. I have significant musculo-skeletal discomfort from arthritis, sciatica, etc. and miss the anti-inflammatory effect of aspirin. Is there a table or formula somewhere online that I could go to and figure out how to adjust the coumadin and get away with taking a 325 mg. aspirin a day and still come up with a therapeutic range PTT? My doctor said I could take a baby aspirin only. Thank you for any input!

PEOPLE'S PHARMACY RESPONSE: ASPIRIN AT PAIN-RELIEF DOSES IS TOO RISKY FOR YOU. INSTEAD, CONSIDER A HOME REMEDY THAT DOES NOT INTERFERE OR INTERACT WITH YOUR COUMADIN.

I am on Coumadin for Mechanical Mytral Valve for about two years. I had my Pacemaker replaced recently with ICD, that resulted in Hematoma at the surgery site of ICD. I was on pain killer for more than a month,that has caused constipation and Hemorrhoids and this is really very painful.

I am using Colace, which has proved very effective before as stool softener, but now it is effective as before. I wanted to know that if Psylium Husks and Prunes will interact with Coumadin.

Hi there, I am have aortic valve replacement with a mechanical valve next week and will be on warfarin... I would usually take homeopathic remedies leading up to and operation and then after especially ARNICA and Hyper/Cal... any advice please as to what i can take to air recovery?
thanks

PEOPLE'S PHARMACY RESPONSE: ARNICA MIGHT INTERACT WITH THE WARFARIN, THOUGH THIS IS STILL THEORETICAL. ZINC AND VITAMIN C CAN HELP TISSUE HEALING.

Have been on Warfrin for 6 years due to 2 separate pulmonary embuli events. I struggle with my diet as I am also diabetic. How does the drug metforman interact with the warfrin and what does long term use of Warfrin have on my body?

PEOPLE'S PHARMACY RESPONSE: WE COULD FIND NO EVIDENCE THAT METFORMIN AND WARFARIN INTERACT IN A DANGEROUS WAY.

Can I fly while on warfarin. Been on it for 2 months (12mg)?
thank you.

PEOPLE'S PHARMACY RESPONSE: DO CHECK WITH YOUR DOCTOR, BUT SINCE YOU HAVE BEEN ONE IT FOR A COUPLE MONTHS IT APPEARS TO BE SAFE.

I had 2 massive heart attacks in 5 days and I am on warafin, is there any natural remedy to replace this as far as you have heard ? ?

I have been taking coumadin for about 15 years and my INR stays right around 1.9 My daughter recently discussed the benefits of taking turmeric/curcumin supplements. Would this pose a risk to my Coumadin effectiveness?

PEOPLE'S PHARMACY RESPONSE: IT MIGHT. WE HAVE HEARD FROM SEVERAL PEOPLE THAT TURMERIC WITH COUMADIN CAN RAISE INR TO DANGEROUS LEVELS. IT WOULD BE BETTER NOT TO TAKE THE TURMERIC.

I will be flying to Hawaii in December 2010. I have been on Warfarin for about 7 years. Should I be concerned about altitude or sitting for a prolonged time now that I take the medication?

PEOPLE'S PHARMACY RESPONSE: WARFARIN IS SUPPOSED TO PROTECT YOU FROM CLOTS.

I have been taking coumadin for 5 weeks and have been experiencing terrible mouth sores and pain throughout. I have been treated for this but unsuccessfully. Spoke with a friend of mine (also on coumadin), she is experiencing the same thing. Can this be a coincidence?

If you are taking coumadin, can you smoke cigars?

Since smoking narrows your capillaries and even though you may not inhale, I would say smoking can be a risk factor.

I take coumadin daily since a serious pulmonary embolism 2 years ago. Is the drug praxada been approved for use in the USA and if so is it indicated for prevention of PE of unknown etiology?

Mom is 85. Had a stroke 6 years ago. Has seriously low bp - 80/50. Takes 2.5mg coumadin and INR was fine for last 5+ years until now. She was significantly dehydrated, doctor said to increase fluid intake as it might increase bp We did (gatorade & vitamin water) and now her INR is 8 and her bp hasn't been rechecked. She is to stop coumadin for three days then continue for the next four. She takes a good multivitamin, levothyroxine, digoxin, celexa, seroqouel XR 150 and simvastatin. She sleeps all the time and has no appetite. Would Vitamin K help? Would other supplements be beneficial? Thank you for your advice.

PEOPLE'S PHARMACY RESPONSE: SOMEONE LIKE YOUR MOTHER ON COUMADIN SHOULD TAKE VITAMIN K ONLY UNDER MEDICAL SUPERVISION.

My husband is taking coumadin for heart flutters he has had since a by-pass.
I have been reading about the heart advantages of hawthorn. I can't find
anything about it reacting with coumadin. but still wonder. Would appreciate
your advice. Also cod liver oil.

I knew lady who had been on Coumadin, she ended up having a cerebral stroke then was taken off Coumadin then put on Plavix. During the time she was on Coumadin and right afterwards she was just mean, picking fights with anyone who crossed her path, she eventually ended up with dementia. I have a friend on Coumadin (wafarin) now and seems to be heading in the same direction. She is unhappy, picks fights with her family who are trying to help. I am afraid she is heading for dementia also. Could Coumadian be the cause or has this been studied? I very concerned. I do not know what other medications she takes.

I'm taking warfarin and my inr have been on good level. Lately I have a red itchy spot in my lower leg, I was wondering could it be a blood vessel? Please help I made an appointment for my doctor.

I was on coumadin for about a year. I had a bad fall and bled profusely with bruises which lasted for about a month. I quit the coumadin.
Am I doing myself harm? I am taking an aspirin a day. sb

PEOPLE'S PHARMACY RESPONSE: COUMADIN IS USUALLY PRESCRIBED TO PREVENT STROKES AND OTHER SERIOUS EVENTS. WHILE THE DOSE MAY NEED TO BE ADJUSTED, IT IS VERY RISKY TO JUST QUIT COUMADIN (WARFARIN) WITHOUT TALKING THIS OVER WITH THE DOCTOR WHO PRESCRIBED IT. HE OR SHE IS BEST EQUIPPED TO DECIDE IF YOU NO LONGER NEED IT.

I had a heart valve replacement about 2 years ago and was put on Coumadin. Since the surgery my knee has swollen up several times and been drained of bloody fluid which the doctors believe is being caused by the coumadin. Have there been any others that have had this problem and is there a solution for it? Also would any of the new drugs they're testing help with this bleeding problem?

I take warfarin because I had a DVT and Pulmonary Embolism after surgery. I also take a multitude of other meds which the Dr. prescribes for me. I worry about interactions with my thyroid med and fish oil which he tells me to take. My PT/INR is checked monthly or more often if needed. Should I be concerned since I have been treated since June 2004 which is nearly 7 years. I take nothing over the counter unless the Dr. tells me it is OK. I have a friend who uses a spoonful of yellow mustard a day for leg cramps. She is on warfarin, too, and her levels have been elevated. We wondered if the turmeric in the mustard could cause this, Thank you for your answers.

PEOPLE'S PHARMACY RESPONSE: WE ADVISE AGAINST USING TURMERIC IF A PERSON IS ON WARFARIN. SEVERAL PEOPLE HAVE REPORTED ELEVATED INR.

I wrote questions on warfarin. I forgot to check the notify me when posted box. I am just adding that I wanted to be notified.

Since having a mitral valve replacement 32 years ago I have been on coumadin. Five years ago I had an estrogen, progesterone, Her2 positive breast cancer. Since the cancer, I eat a diet heavy with green vegetables, and use turmeric, ginger, cinnamon and chia seeds (about 1/8 of a teaspoon each on my foods.) I drink 2-3 cups of green tea and a bowl of steel cut oatmeal a day. I own my machine and test my INR 3 times a week and keep my INR in range. What should I know about the interactions of these natural foods and spices with Coumadin and breast cancer risk? Thank you.

PEOPLE'S PHARMACY RESPONSE: THE RESEARCH THAT HAS BEEN DONE ON TURMERIC AND ITS ACTIVE CONSTITUENT CURCUMIN IN BREAST CANCER IS ALL BASIC RESEARCH, MOSTLY IN TEST TUBES. IT LOOKS QUITE PROMISING, BUT IT IS ALL STILL VERY PRELIMINARY AND WE DID NOT FIND CLINICAL TRIALS.

FOR YOUR OWN N OF 1 TRIAL, WE RECOMMEND YOU CONTINUE TO MONITOR YOUR INR CAREFULLY. WE HAVE HEARD FROM SEVERAL PEOPLE WHO FOUND THAT TURMERIC COULD POTENTIATE THE ACTIVITY OF COUMADIN AND RAISE THE INR OUT OF THERAPEUTIC RANGE. IN THEORY, (NO EMPIRICAL DATA) GINGER COULD DO SOMETHING SIMILAR. IF YOU ARE KEEPING YOUR INTAKE STEADY AND MONITORING YOUR INR, THOUGH, THIS SEEMS A REASONABLE EXPERIMENT.

DO KEEP IN MIND THAT GREEN TEA IS RICH IN VITAMIN K AND COULD REVERSE THE BENEFITS OF COUMADIN. THIS INTAKE ALSO SHOULD BE STABLE FROM ONE DAY TO ANOTHER.

Will red peppers hurt me if I take 5 mg of coumadin a day? My coumadin has been high 5 or so. I should have 2.5.

PEOPLE'S PHARMACY RESPONSE: RED PEPPERS CAN INTERACT WITH COUMADIN. HERE'S THE MECHANISM: CAPSAICIN IN HOT PEPPERS INHIBITS CYP1A2, AN ENZYME THAT METABOLIZES R-WARFARIN, ONE OF THE VARIETIES OF WARFARIN IN COUMADIN. INHIBITED ENZYMES MEAN HIGHER BLOOD LEVELS AND HIGHER INR.

I have been on coumadin for 30 years (I am 50 with activated protein c deficiency) and in the last several years have been having a lot of trouble with the sun. My body ends up with "sun bumps" but only where the sun has actually touched. They itch horribly and almost like very tiny blisters. Someone I know, also on coumadin, told me it could be the med. Is this true? It would really explain everything.

PEOPLE'S PHARMACY RESPONSE: WARFARIN (COUMADIN) CAN CAUSE SEVERAL DIFFERENT TYPES OF SKIN REACTIONS. PLEASE ASK YOUR DOCTOR ABOUT THIS, SINCE PROTEIN C DEFICIENCY COULD PUT YOU AT HIGHER RISK.

I am a nurse who works with patients on Coumadin. We have a patient who recently switched the timing of his Coumadin dose. He used to take it at bedtime and now he is taking it around supper time. His last INR went up dramatically.
He denies any dietary changes (eats a consistent quantity of green vegetables daily) except that he might be drinking more water than previously. Could taking Coumadin with food increase his absorption of Coumadin or in some way potientiate it's effect? Or could drinking more water make a difference?

I am a female 43 yrs old. I had a stroke in November 2010. I have a blocked carotid artery. Under doctor's care, I had been taking 5 mgs of Warfarin and having my pt/inr tested every two weeks. I started seeing a different doctor in March. She directed me to up the dosage to 9mgs and did not test my blood until the middle of April. It takes one day for the results to be returned. That Thursday, the doctor's office called me and told me to go directly to the Emergency Room because my pt/inr levels were 6.2.

The physician at the ER gave me a dose of Vitamin K and a dose of potassium and told me to stop taking the Warfarin over the next 4 days and followup with my doctor on Monday. My doctor didn't even schedule a followup appointment when I asked. There was a pt/inr test done at their lab, and the results came back Tuesday, and my doctor, once again directed me to start taking 9 mgs again, and will have another test done in two weeks.

The first time my pt/inr was elevated I developed hemorrhoids and I am starting to get them again. Are the hemorrhoids caused by the Warfarin? I feel like I am being over-medicated again!

Any input is desired.
Thank you

PEOPLE'S PHARMACY RESPONSE: IT'S CLEAR THAT YOU NEED MONITORING MORE CLOSELY THAN YOUR NEW DOCTOR IMAGINED. YOU WILL NEED TO NEGOTIATE THAT WITH HER. IF SHE DOESN'T SEE THE NEED AFTER THIS, YOU'LL NEED TO FIND A DOCTOR WHO CAN PARTNER WITH YOU BETTER.

I have been taking Warfarin for 10 years and have recently awakened at night and see the white night light in red color. What could this mean if anything? Is this a common experience? Thank you

PEOPLE'S PHARMACY RESPONSE: PLEASE ASK YOUR DOCTOR ABOUT THIS. WE ARE NOT FAMILIAR WITH THIS SYMPTOM AND DON'T KNOW IF IT IS WORRISOME.

Last year I had PE that sent 10 blood clots to my lungs (yes Jesus is good I'm still here!). I'm 42 and want to do the Lemonade Diet "Master Cleanse", can I do that? I'm on 7mg of Coumadin a day.

My husband is taking Coumadin 5 mg daily, and wants to take Vitamin E. Is there any contraindication to including Vit E in his medication regimen? Thanks

PEOPLE'S PHARMACY RESPONSE: VITAMIN E IS USUALLY ON THE FORBIDDEN LIST, WITH THE EXPECTATION THAT IT MIGHT INCREASE THE RISK OF BLEEDING. IT IS NOT ENTIRELY CLEAR HOW STRONG THAT INTERACTION POTENTIAL MIGHT BE. HERE IS ONE STUDY: http://www.ncbi.nlm.nih.gov/pubmed/19401475
WE RECOMMEND THAT HE DISCUSS THIS WITH HIS ANTICOAGULATION TEAM.

if taking coumadin do not take glucosamine condroiten for arthritis it interferes with the coumadin.

I am taking warfarin. I wear knee shorts in the summer. My legs have a rash on them, I was in the sun two hours. . Is the sun bad for your skin if you are on Warfarin?

PEOPLE'S PHARMACY RESPONSE: RASH AND DERMATITIS ARE POSSIBLE SIDE EFFECTS OF WARFARIN, BUT WE COULD FIND NO EVIDENCE THAT IT INCREASES SUN SENSITIVITY. PLEASE BRING THE RASH TO YOUR DOCTOR'S ATTENTION.

I am flying Thursday 14th. I am on warfarin which gave me a stroke when I first went on it, my question is, can I take sudafed decongestant when flying out and flying back again as I suffer terrible pain in my ears, despite trying swallowing, blowing my nose etc...

I have the same issue.. what did you learn?

I have recently been diagnosed with Osteoarthritis in my left knee, my Primary says there is nothing she can give me because of the Warfarin & blood pressure meds I'm taking, I asked what can I take for the pain & swelling, she replied "nothing... use a heating pad & walk" no seems to be her response to everything.

Can I take something like Osteo Bi Flex? I don't like taking Acetaminophen, it doesn't do much for the pain. I do keep active & I walk 20 blocks 3 to 4 days a week. What would you suggest I do to help with the pain & swelling? I have an upcoming appt. with my Cardiologist & like to go informed, he does give me much more wiggle room than my Primary. Any help you give will be greatly appreciated. Thank You!

PEOPLE'S PHARMACY RESPONSE: YOUR PCP IS RIGHT THAT WARFARIN DOESN'T PLAY WELL WITH NSAIDS LIKE IBUPROFEN, NAPROXEN, DICLOFENAC, ETC. YOU MIGHT CONSIDER SOME HOME REMEDIES.

I just started taking warfarin 4 weeks ago. I am extremely tired all the time, some times have to stop and nap. Anyone else have this problem.
What about the new drugs? do they have all the problems as warfarin?
Thanks

PEOPLE'S PHARMACY RESPONSE: COUMADIN DOES SOMETIMES, BUT "INFREQUENTLY," CAUSE: fatigue, lethargy, malaise, asthenia. BASICALLY, TIRED ALL THE TIME. SO YOU ARE NOT ALONE.

THE NEW DRUGS HAVE THEIR OWN SETS OF SIDE EFFECTS, BUT ALL ANTI-COAGULANTS CAN CAUSE EXCESSIVE BLEEDING.

I take Coumadin 2mg on Tues, Thurs, Sat and Sunday... I also take D3, Fish oil, Vitamin c. I have taken Arnica Montana when needed b/c it relieves my aches. Would any of these cause a elevated PT/INR?

PEOPLE'S PHARMACY RESPONSE: IT IS POSSIBLE THAT FISH OIL COULD POSE A PROBLEM. WE DON'T THINK IT IS A GOOD IDEA TO TAKE ARNICA MONTANA BY MOUTH; SMEAR IT ON TOPICALLY INSTEAD.

TO LEARN MORE ABOUT INTERACTIONS WITH WARFARIN OR OTHER DRUGS, VISIT MEDIGUARD.ORG.

I found out on my birthday this year, that I should have been on coumadin for only six months instead of 10 years. I don't have a life anymore, too many side effects, can hardly walk. Lost a lot of hair, gained a lot of weight, I hurt from top to toe. My stomach is messed up, had blood blisters hanging out of my eye. Severe itching, bruising, dry mouth, nausea and the list goes on. I mentioned all the problems I had to many doctors and finally one listened. He acknowledged that the blood clots only formed during/after a surgery. 10 wasted years, ask me if I am depressed now..... I am furious!

My heart went into a-fib after knee replacement. I was prescribed amiodarone hcl 200 mg and coumadin. I am now in sinus rhythm. I have hypothyroid, and am diabetic ii. Please inform me as to the safety of these medications and what other drugs they react to.

PE about 5 yrs ago from 2nd urinary surgery. Saw palmetto extract 320mg, 15yrs seems to curb the BPH. Am on warfarin, but having urinary problems at night (5-6 times). Urethra seems restricted at night and I've been impotent for about 15 years. I'd like to try progesterone transdermally (20mg) to ease the urinary problems, but am concerned it will increase the clotting time. I'm talking to my physician Monday to see what he has to say.

Which herbal supplements should be avoided when taking warfarin? Specifically, are any of the following harmful-- Niacin, saw palmetto, maca, L-Arginine, horny goat weed, vitamin B complex?

Have been on warfin for about 1 month and am now having pain in my back and
down in my foot. Could this be a connection to the warfin?

I'm trying to find out if Hawthorn Berry is ok to take with with coumadin? I take coumadin for a blood clot I had years ago. Can you have hair loss from taking coumadin?

I didn't know this could be a side effect, until I read some of the earlier comments.

I went into hospital A&E dept a few months ago with a pain in my leg, which they suspected as being a clot as I had just flown back from a holiday days earlier, I was admitted and for six days pumped full of double doses of coudamin injections in my stomach daily.... I was found to not have a blood clot after all and left hospital, but since the injections stopped the breathing difficulties have started, I have not felt right since, have been having checks done for all sorts... but so far all seems to come back as ok, I on the other hand still find breathing is difficult and chest and back pain still going on.... I was ok before these injections only had a pain in the leg which incidentally has gone now.... all web sites tell you to seek help if you have breathing difficulties after taking this drug, but my doctor doesn't seem to believe it would cause me problems, and what could be done for me, I need to know what damage or reaction and cure is there for me now.... who do I go to for help?

Hi....now that you are off coumadin did your side effects disappear and how long did it take? I was on this stuff for 18 months and now 6 months later still feel awful.

Thanks

I am on 10mg of Coumadin daily and will soon be spending 6 weeks in South America, some of it at altitude.

Internet blogs, based on just one research study that I am aware of, suggest that altitude decreases the INR levels. Unfortunately GP's that I have visited are not "up to speed" on this issue so I have a few questions:-

(1) Is there any more detail on what percentage the INR drop at altitude?
(2) Can one buy a portable INR tester that uses a similar principle to the one available to diabetics?
(3) What strategies could be used to minimise the risk (assuming not going is out of the question)?
(4) Assuming that I found a doctor in South America who could do an INR test, would I need a referral from my GP (in Australia)?

Thanks in advance for any advice that you can provide.

I have been on Warfarin since Sept of 2007. I don't know what kind of blood disorder I have. The amount of Warfarin I've been on has changed so much. I went from 5mg to 17mg and now currently on 10mg. I do have trouble with headaches, gum bleeding, and feel real tired. Is there another type of blood thinner that has less side affects? I did have 2 surgeries to remove 2 blood clots in my left leg in 2007.

My cousin takes many medications and has been diagnosed with blood clots in the lungs, pain, knee,cholesterol (high), low thyroid, high blood pressure, asthma, incontinence, calcium deficiency, anxiety, depression and takes the following: Warfarin, Vitamin D, Hydrocodone, Altrazolam, Alendronate Sodium, Anastrozole, Levothyroxine Synthroid, Venlafaxine, Atenolol, Tricor, Lisinopril, Gemfibrozil, Pravastatin Sodium, Ventolin HFA, Sanctura XR.

Her biggest problem comes from the incontinence which started when she was diagnosed with the blood clots in the lungs. Nothing has helped. Could any of her drugs be reacting together to cause incontinence? Any suggestions?

I take warfarin and I was cutting some peppers, and I must have gotten some on my left hand and it has been burning for hours now. Can this be a reaction to my warfarin?

I had a PE 8/01 and another 01/02. I have been on Warfarin. The dosage has fluctuated from 12 mg daily to now 8 mg daily. Warfarin is the only med I take. The cause of the PE was work related. I drove across country and flew back to my home each week. Too much time in the car between breaks was the conclusion of my MD. I started taking Warfarin and I would take a break every 100 miles or so and was sure to get up and stretch my legs on the plane. I went to all the cumaden clinics and read all the related information about the affects and issues with that medicine. Because of my work I had blood test when I went in to the doctor. Never weekly. Never Monthly. Never regular.

Now, after a job, insurance company and doctor change in 09/11 my new doctor is demanding weekly blood tests, a cumaden management clinic and weekly phone calls where an office worker asks me detailed question about my stool, what I ate, how much did alcohol I drink this week, what over the counter drugs I take. Way too much personal information to be given out over the phone. They have called me and told me to take 4 mg extra warfarin NOW, wanted me to pop into the clinic for a blood-audit (unscheduled and in addition to the weekly test). Neither of which I did. I went to this doctor to have a prescription refilled... not management.

I missed my weekly test 3/2 and the doctor's office sent a registered letter demanding I report for blood testing and included a drug contract I HAD TO SIGN AND AGREE TO or he wouldn't refill my warfarin prescription.

I feel like I am being bullied and it really scares me. They are acting like they are the ones that discovered my condition and demand I go through all the requirements I did back in 2002. I am not a new patient. I am not a new warfarin user. I am not a teenager. I am 60 years old.

I had a good regimen I followed for MY healthcare.

A pharmacist from the clinic called me on the phone and demanded I get to the clinic immediately and that they had the right to MAKE me submit to blood testing. I was so upset I had to hang up on him.

I am in the process of changing doctors but I am stymied by this Healthcare firm. They have me locked into these medical homes I have to choose from so it is difficult to pick one. My other choice is to go out of Network and pay almost the full price.

Has anyone experienced these type of rigid requirements for warfarin?

I am in relative great health. I watch what I eat for the vitamin K content, etc. I don't drink alcohol ( even though this is one of the requirement I have to agree too ).

I am confused!

Don't let any doc bully you. It happened to me also, he had me go to the lab three times a week. Remember there is money they make every time they send you. I found out I was on it for ten years for nothing. Docs had made a mistake..... Please change doc until you get the right one who is on your side, not the insurance company side. I understand it isn't easy but don't give up. Your thinking is correct, theirs is confusing ;-)

I was diagnosed in January 2012 with a large Pulmonary Embolism. Immediately they began the blood thinning shots and oral warfarin (although I had probably had the condition a long time... as I had sought help from several doctors, being short of breath, actually gasping for air while just walking to another room!)

I was given antibiotics... bronchial dilators, antihistamines, expectorants... all without any fever or farther testing... one Dr. did have a chest x-ray done to eliminate pneumonia... and pronounced me "normal"... I was encouraged to "exercise more"... with me panting for breath... gasping for air... but curiously my oxygen would bound back when I could breathe a few min at rest.

Finally I got to a pulmonary doctor who suspecting a clot... ordered a scan which showed it vividly... on my lung (right lower lobe) arterial supply... actually it has branches like a tree. This was in January 2012 and I have been on the warfarin at some dosage since then.

I was troubled with the side effects, reading here of other's complaints, at least sorta confirms my suspicions that warfarin is to blame... even though it seems necessary if I want to ever get rid of this monster keeping me from breathing.

I was initially resistant to getting enough level, probably because I loved the leafy greens full of vit K... then it fluctuated wildly... going high, my eye began bleeding.. (at 3.8 level).. stopped few days then lower dose. (1.5 reading).. then high again...(3.2)

But reading here the spices cayenne, mustard (with turmeric) ginger and even cinnamon... I had been sporadically using was probably responsible for the wild fluctuation I had been experiencing...

Thank you all for the input of your experiences...at least I can be aware of these things and maybe my Doctor (who seems very concerned) would be interested in the additional information.

Also if anyone has successfully had a pulmonary embolism dissolved by an alternative drug or method... I would like to know. I do have the tiredness... swollen ankles... grouchy/ crying/ moody/achy symptoms... associated with this therapy.

Thanks!

I have been on coumadin for a year now just got some bruises that appeared out of no were one is painful, should I be concerned?

I have been on Coumidin for six years now due to mechanical mitral valve replacement. I travel a lot and of late even short flights results in fatigue and headache for a few day after my flight.

Two questions:
1. Is altitude/air flight effected when on coumidin?
2. My wife and I are scheduled to travel to Europe in June/2012 and my recent symptoms have me concerned about flying on coumidin?

Is there any documentation of Coumidin's effect on flying?

Would appreciate any data. Thanks

I have recently returned from 6 weeks in South America, some of it at altitudes of up to 14,000 feet.

Although my questions (see my post above on 23/1/2012) were not answered I do have some comments:-

1. Being at altitude lowers one's INR reading according to a USA research study done some years ago in the Colorado ski fields. Do a google search with key words such as "INR, altitude etc" and you will find it - unfortunately the results are not as specific as you would like.

2. I don't think that being in an aircraft will affect INR as the aircraft is pressurized. But being outside at altitude will (based on the study). If you are going to be in say, the Swiss Alps, your INR levels will probably fall.

3. My INR's were at the upper end of the therapeutic scale (2.8) when I left Australia for South America. When over in SA I increased my daily dose from 10 to 12mg but only when at altitude. When I returned to Australia my INR was 2.9. I didn't have my INR measured in South America so can't say what my INR reading was at altitude.

4. What also worked for me in avoiding altitude sickness was to drink plenty of water and coca tea (not sure if you can get coca tea outside South America). Neither alters INR readings as far as I'm aware but will reduce the chances of fatigue and headaches.

Hope this gives you some ideas.

CB

I have red blue patches on my feet and ankles in time it seems to travel up my legs. I am on warafin could this be a problem?

I commented March 26 about side effects of the warfarin I was prescribed for a large Pulmonary Embolism...nasty as the stuff is...it seems to be effective...after a follow-up scan in late April...it was pronounced "dissolved"!

I was disappointed that my doctor wanted to keep me on the warfarin (same dose) as a preventative measure against another clot...I have cut the dosage, against my Doctors advice, seeking alternative medicines. I hope I am not making a mistake...but I considered continuing with the constant exhaustion, moodiness and swollen purple feet...to be not much quality of life.

I consulted a Natural Doctor...who recommended "Butcher's Broom"...and as I decreased the warfarin (now stopped completely) I added "CircuFlow" that was recommend by another herbalist...the first day on the "Butcher's Broom"...I noticed my dry eye problem (had been bothered with a year prior to the clot and warfarin)had improved to where I no longer need eye drops nor do my eyes hurt. (Still my eyes are red rimed like from the warfarin....but I am wondering if the herbs are having a blood-thinning effect like they are suppose to have.)

I am feeling a little better...not wanting to sleep all day...my oxygen is holding up pretty well...I definitely recommend having a small finger checking oxy/pulse/ometer...worth much more for peace of mind, than the cost! Actually my optimism is back and I can see humor in a lot of areas of life that the warfarin seems to have obliterated. I am able to think more clearly...not totally better but I can see improvement from the foggy gloomy feeling that had engulfed me!

I wouldn't recommend going against Doctor's orders, except for the most foolhardy among us! BUT I would be interested to hear a response from any others who have replaced or supplemented the warfarin with alternative methods, such as I have done...and the outcome of doing so.I have been taking these alternatives about 3 weeks after about 4 1/2 months on the warfarin. I will be 70 years old in July...so I'm hoping these alternatives are not a mistaken choice.

I was thinking about adding "astaxathin" I had read about...I hope to hear of any experiences others may have had, good or bad! I appreciate any input!

PEOPLE'S PHARMACY RESPONSE: We too hope you have made the right decision for you. There is no good research that would provide decision support for either doctors or patients on replacing warfarin with herbs. It would make us nervous, but you are making your own decisions. Do communicate with your doctor about what you are doing and what effects you notice so that there can be a rescue plan in place if you need it.

I have been on warfarin for three months due to a blood clot in my left arm, caused by the iv put in b4 my knee replacement surgery. My primary doctor suggests I be on for an additional 3 months. He said as a general rule blood clots reoccur after 3 months if taken off of warfarin. My hematologist says that 3 months is sufficient enough. I would like your comments on this decision. thank you in advance gc

PEOPLE'S PHARMACY RESPONSE: It is really difficult for patients to get conflicting advice from their doctors! Unfortunately, we really aren't capable of telling you which one is right.

I was on coumadin for a year for a dvt/pe, and complained of feeling tired all the time and needing naps (I'm in my mid-40s). I recently stopped the coumadin (I'm done, yay!), and while it took maybe a week, I feel less tired. However, I was told by my regular doctor and the hematologist that fatigue is not a known side effect. It may not be common, but it does, I believe, happen.

I'd also like the answer to this one!

I took warfarin recently for a PE and complained of tiredness, moodiness, depression and my feet were so swollen and purple I could hardly walk...the doctor denied that it could be the warfarin...

Well after the embolism was deemed dissolved...against my doctors orders I cut down and got off the cumiden...well I am still tired...but better mood...not quite as tired and feet less swollen...

I am wondering how much of the bad effects were from low oxygen? With a clot obstructing normal blood flow, looks like that in itself would make you lethargic...but if low oxygen were the cause of the tiredness (rather than the warfarin) looks like when the clot was dissolved...the tiredness...would go away too.

I am prescribed Coumadin for my A-fib attacks back in January 2011. I usually have my INR checked every one to two weeks and it is up and down. Never remains within a good range for more than two weeks. I take 5mg around 5pm each day. My concern is my primary doctors say I can eat the forbidden foods but in small quantities and they will adjust the Coumadin. I do feel tired most days and have bouts of diarrhea two or three times a week. Can Coumadin cause this? When I eat the listed foods that have a bad reaction with Coumadin, I find I eat almost all of them occasionally. Should I eliminate most of them? And which ones are more important to discontinue?

I would appreciate your answer re this problem. Thank you.

I was told that you only need to be consistent in your intake of Vitamin K for it not to affect your INR results in an up-and-down manner -- that your doctor will then tailor your Coumadin dosage to your hopefully more consistent INR results. I do think that the older you are, the more difficult it can be to regulate your INR; there may be other factors besides the Vitamin K at work on your INR as you get older. My mother-in-law had to go for her INR every couple of weeks, but at almost 30 years younger, I only had to go, at the end, every couple of months.

You can Google Coumadin and Vitamin K Foods, and you'll get a list of the foods and their amounts of Vitamin K, and you can try to keep track of your intake that way. Of course, leafy green vegetables (spinach, kale) are some of the highest in Vitamin K, but I was also told to avoid cranberries & cranberry juice, and tea.
I was tired all of the time on the Coumadin, although I was told that this isn't a known/reported side effect -- although I think WebMd does list it as a less common one. I don't know about the diarrhea. If you were on the Coumadin temporarily, I would think you might more easily consider avoiding certain foods (I did at the beginning), but I don't think that's probably realistic on a long-term basis.

I imagine this can be very frustrating, because it's not like you can give up food!
One note: I was told to take the Coumadin before bed, so it was several hours after I'd last eaten -- maybe taking it at 5:00 (and perhaps closer to dinner) is making a difference -- it might be worth asking your doctor about the timing of with/without food?
Good luck!

I may not have the right answer... but like the doctor says a small amount of the foods on the list... but it seemed like (and my levels fluctuated wildly for a while) it can be influenced by the diet, but "balance" seems to be keyword!

If you know which foods decrease the warfarin/cumidin effect like broccoli, greens and such... and which increase its effect like cinnamon, hot and spicy foods... you can balance your diet... that is probably what your doctor meant. Because, if you are on the drug very long you will be malnourished eventually by not eating proper foods in fear of it altering your levels... like your doctor said... the dose of blood thinner can be monitored and altered when needed.

If you don't have lists of foods that alter this effect... and just eat randomly it can fluctuate wildly... and be scary. So get lists of foods that increase... and foods that decrease the levels.

My experience with it was a learning curve... in the beginning (my normal diet was a lot of salads and raw veggies... good diet? right?) but I was resistant to the blood thinning drugs and had to increase the dosage a lot.

Then I left off broccoli... and most vitamin K foods... but being unaware... I ate spicy hot foods and had cinnamon toast for breakfast several mornings... Well... my level jumped up... my eyes actually seeped bloody stuff... dosage down lower.

So I just ate a small amount of the broccoli but made sure I put a little hot sauce (Franks hot sauce was good) if not on the actual greens on other food at same meal... from what I hear... the important thing is to be consistent... don't eat all spicy hot food and cinnamon one week and all greens another... or you will probably bounce your levels like I did... but keep track!

Finally I learned to balance the foods and my level stabilized. I am no expert but I hope this helps

I have been taking warfarin for three weeks, I have a clot below the knee. My question is, dose warfarin affect your cholesterol levels? I never had a problem before. this dr. visit it was up. could it be the medicine?

Jennifer,

I have taken Coumadin and I believe the directions said "stay out of the sun"...I have experienced that itchy rash...where the sun touched....it may have been worse with the coumadin...but I definitely had this happen to me before I ever took Coumadin...only for the last few years, I have noticed this "rash"...which I attribute to a sun reaction to the many new pollutants in our atmosphere.

My husband used to rub ice on the places and it seemed to help the itching a little....I used an anti fungal cream it seemed to help...but we never knew WHY this happens in the sun.

Bringing up another possibility...being exposed skin, subject to the sun but also falling particles ...all that smut, smoke, even radioactive debris...that goes UP...has to come down somewhere!

For instance when your car is parked outside...ever notice a film of smut and crap (not birds kind)...the residue is sometimes oily...that is what I am talking about...it has to be falling on us too, getting on our exposed skin.

It may be two different issues...but the "rash" you described...even the tiny bumps...and itching...sound just like what we had without and before the coumadin...as much as I would like to blame the drug...and even though it could have exacerbated the condition some(hard to compare itching), I cannot blame this rash wholly on the Coumadin.

I did have the swollen feet...purple and puffy... felt hard , tight and painful...I blamed the Coumaden...but it was a necessary evil;..It DID dissolve the clot.

Afterwards, against my doctors orders I tapered off the Coumaden thinking my feet would quit swelling...Well after a first hopeful improvement they are still swelling...My feet have never (prior to taking the Coumadin)swelled like this...and I'm almost 70 years old! I wonder if the original swelling could have damaged my circulation...

I would like to know if anyone else experienced the swelling feet..or the "rash", and if it improved after stopping the Coumadin.

Thanks for any input!


Summer has been extremely hot and humid in Michigan, being a home care nurse what can I tell my pt on Coumadin about sun exposure??

I also have sore tongue as in small cuts and split tongue, non bleeding. My doctor also has not said this could be a side effect, but this only started after being put on warfarin. Has anyone else got this and know any treatment for it?

does taking coumadin together with pure melatonin have any contraindications?

I have been on warfarin for about 2 months. (30 mg a week) and am having a very difficult time with bouts of daytime sleepiness. It's as if I HAD to sleep. This happens usually several times a day. I am 78 years old, and usually very physically active (until now.) The prescription is the result of double pulmonary embolisms combined with a deep vein thrombosis. It makes a normal life impossible, and I am getting depressed with its social interference. Is this likely to back off with time? Is there a way to offset the effect?

Hi am 38 and been on warfarin for 2 months after having a c-seection, am constantly tired and short of breath sometimes. Had a scan 2 weeks ago but they couldn't find the clot????... Am still taking warfarin 9/10 mg on alternate days, and am on regular INR Checking. Am a bit confused now because if I don't have the clot anymore why am I still taking the warfarin?

My Gp seems clueless in regards to this, the anticoagulant clinic nurses are the ones who tell me what doses to take ( which appears to be guesswork what dose I should take), am having painful piles now and not sure why as I drink a lot and my diet is ok, just wondering should I stop taking the warfarin now or continue for a further 4 months ad the anticoagulant nurses say ?

Wilma, I don't know if you read my earlier comments, I was on various amounts of warfarin earlier this year... I would not advise anyone to go against Dr's orders; I can only tell of my own experiences with this drug. It seemed to fluctuate strongly (testing levels) and I noticed when it got real high I had inadvertently eaten cinnamon and hot sauce frequently... they cut dose or stop few days then I ate broccoli/slaw and it would be low and they increase dosage before I realized how delicate the balance of my dosage and levels corresponded with my diet.

Well I began eating more vit k foods (get a list online) but tried to balance by putting hot sauce on my broccoli (Franks Hot sauce was tasty and not too hot)or stir fry veggies over rice.

Re:piles/constipation even though you have a healthy diet, did you cut out leafy greens like kale with a lot of vit k? That is where the list of foods with levels comes in handy, because you can avoid meals same day or consecutively heavy on vit K. or know to add a little cinnamon or hot sauce!(This will stay true even if you stopped the warfarin at some point)

I too felt sleepy and tired all the time, my feet swelled and felt numb, I felt groggy and fuzzy headed while on warfarin. But I am older and did have a large pulmonary embolism, even though I hated taking the warfaren... it did dissolve the clot with no mishaps other than feeling rotten which is still better than being dead.

After they verified the clot gone, by cat scan, I had expected to get off that pesky drug and not have to keep being tested so often. But they wanted me to continue as a preventive.

Each of us are different in response to drugs and while I would never advise going against Dr's orders... after much thought I researched, consulted a natural Dr., a herbalist and a nutritionist, even discussed it with my pulmonary Dr., a wonderful understanding Dr., asking him if any alternative drugs, herbal teas or vitamins might work. I realized he could not condone my stopping what is accepted protocol in his professional practice.

But faced with the taking of this drug "forevermore" or chancing a repeat clot, after much soul searching I decided to try weaning off the warfarin and trying some of the alternatives. My reasoning was if I got another clot, and it didn't kill me immediately, I could take warfarin then!

I had noticed that when my tested levels were high my eyes were red rimmed and even bloody whites when real high, so I could monitor in a not so perfect method.

Anyway, against my Dr. orders I ventured into unknown self monitoring. My feet swelling had been one of the nasty side effects I blamed on the warfarin and I was real dissapointed not to immediately feel great. Seems like they got better a while, then swelled again darn. I did notice I seemed to think better, a bit more clear.

Nothing seems perfect, I had good results with "butchers Broom" (from the natural doctor) and felt better a while, I am breathing better with the clot gone and my oxygen had stayed good. I am overweight, can't seem to lose it, tire easily and feet and ankles swell a lot.

You are young and if you had a c section, does that mean you have a new baby? That alone will keep you exhausted... Anyway I hope you find what's right for you... I would say to everyone... search... read... consult several Doctors until you are comfortable with your treatment and ultimate health!

Thank you JT for your reply to my post, that was very helpful. I do understand what your saying about me having a baby coz he has constant demands but the kind of tiredness I feel is not from that, I've got 2 other children from previous c-section and never felt like this before, even though the baby can be demanding I have a wonderful family that helps look after him. You are lucky to have an embolism doctor, after bring diagnosed with PE I was sent home with warfarin and only referred to anticoagulant nurses, it's been 3 months now and I have not seen or heard from any doctor regarding the PE, when I asked my General doctor he was completely clueless as to what the next step will be, the anticoagulant nurses said I will take for 6 months then stop as my clot is probably pregnancy related.

I just don't like the way I feel anymore I don't feel like am myself, I was previously healthy working full time (over 40 hours a week), and now I can't even make my family a meal without feeling exhausted, I miss going out for shopping as am now doing it online and I've now added weight, which doesn't help! It's a vicious cycle, I was admitted in hospital a couple of weeks back due to chest pains and had an echocardiogram to see if my heart was ok and Thank God it came back normal am to have a lung function test am praying all will be well, I still wonder if I need to take the warfarin for that long as the last scan showed no clot, am now worried of what will happen if I suddenly stop taking the warfarin even if its after 6 months, am also worried about the effects of warfarin if my body doesn't need it as the clot is not there anymore.

Am doing research whenever I can to see if I can find more info. In the meantime I will carry on taking the meds as the benefit of taking out ways not taking them, as I wouldn't want to develop another clot, but the side effects are awful and have made a big impact on my life, if there is anyone out there with more information pls keep me informed on what's best to do
Thank you.

I have the same issue. Very dry mouth and throat, dry lips to the point they are started to get painful, my mouth feels like its full of cotton balls and my taste is about gone, and the tip of my tongue hurts. It's gotten worse over the past month. I've been on coumadin for 4 months after a PE episode. Checking with my pulmonologist tomorrow. I can't continue living this way.

I am experiencing the same issues and my pulmonary doctor said it was not caused by coumadin since she has other patients that have never complained about that. I do use a CPAP and the doctor said to increase the humidifier level and wash my mouth out with a non alcoholic mouth wash three times per day. I have not changed any of my other meds so I'm suspicious. I am to phone her back in four days if there isn't an improvement. My family doctor said those problems are associated with coumadin. I'm going to seek further advice and let you know what I find out.

Not a coincidence as far as I'm concerned. Myself and others on this blog are experiencing the same thing. Doctors say it's not a side effect but obviously it is since there are those out there like us experiencing it. Doc told me to use a non alcoholic mouth wash three times per day. I am to call her back in two days if it doesnt do anything. So far it doesnt do a thing. I have dry mouth, sore inside and on tounge and dry cracking lips. Pulmonary doc thinks its related to CPAP I use every night but I've been using it for 8 years without an issue. Will get back to you when I find out anything.

There are many of us who experience the same issue but the doctors out there deny its caused from coumadin. I disagree. I am having the same issues. My pulmonary doc suspects the CPAP I use nightly for sleep apnea but I've been using it for 8 years without an issue until I went on coumadin. Pulmonary doc said try Biotene (non alcoholic mouth wash) for four days and increase level of humidity in CPAP and let her know. In three days no improvement at all. I am sure its caused from coumadin. My eyes show redness and face looks likes I've been out in the sun for a couple days. My lips are cracking and bleeding also. Will let you know what if anything resolves my issues.

I have been on coumadin 5mg, with occasional double dose for two days if INR gets below 2, for 4 months because of a PE.

The past month I noticed a continued increase level of dry mouth, tongue, sore inside mouth and mouth side walls, pain underneath tongue and tip and dry cracked lips. My pulmonary doc suspects its a CPAP issue but I've been on it for 8 years without an issue. I've been directed to increase humidity level and wash my mouth out with Biotene (a non alcoholic mouth wash) several times a day and call her back if there is no improvement. 3 days and its only gotten worse. I have slight nose bleeding, redness in the face and redness in the eyes. Family doc said my symptoms are side effects of coumadin so there's conflicting responses.

It may be a rare side effect but there are others out there like me experiencing the same side issues. Anyone out there having the same conditions please reply and maybe between all of us it can be resolved.

Went on holiday in October to dubi since coming home my inr has yo-yoed every week, feeling really tired all the time. Does any body have the same affects?

This could be due to a combination of change of diet (eg. vitamin K-rich green vegetables will decrease your INR) and perhaps the excitement of a holiday with its inevitable let-down at the end and possible jetlag may make you weary.

Having said that, after 6 weeks last year in South America my INR remained constant despite the lack of green vegetables over there.

Of course different people are affected in different ways.

If anyone can provide any information it will be very helpful. My Dad is nearly 87 ad he has been in convalescent care for 11/2 years during which time has been on 2.5 mg of Warfarin. Not long after starting the medication he began to tell me that every food that was served was salty, spicy and generally over seasoned. He hardly eats anything.

Not long after that he began to complain about a serious back itch with no rash or apparent change in his skin. He will not let them put him in a sling for a shower, he insists on a bed bath. I am wondering if the lack of a regular shower may be the cause of the extreme itch and perhaps this aged taste buds can't handle the simplest of seasoning,i.e. salt and pepper. And that his itch can be attributed to lack of circulation. He is always laying on the bed and rarely sits in a chair. He has no strength due ti inactivity and can no longer walk.

Has anyone had either of these side effect and was it caused by Warfarin? Did anyone discover anyway to control these side effects if they are indeed related to the use of Warfarin? Any information will be helpful. Thank you!

A pharmacist related that a client who was experiencing pain from peripheral neuropathy stopped taking Coumadin and the pain stopped entirely. Any connection?

PEOPLE'S PHARMACY RESPONSE: Coumadin can cause tingling, numbness, or chills, but we were not aware it would cause neuropathy.

I've taken warfarin for one year since last Sept. 2011 when I got my pacemaker, I have felt so lousy ever since, head aches, balance is worse, indigestion, feeling terrible exhausted, even has effected my thinking, hurting in my legs, & several places in my body muscles, I don't feel normal at all. I feel like I'm allergic to the darn drug.
What can you tell me?? I've talked to my Dr. about this too but with no idea of what can be done.
Thank You!!!

PEOPLE'S PHARMACY RESPONSE: Fatigue, indigestion and headache are common reactions to warfarin. But with a pacemaker, you need to make sure your blood doesn't clot and cause a potentially lethal problem. There are other anticoagulants (more expensive ones), but we do not know if they would make an appropriate substitute for warfarin for you. Perhaps your doctor does not know, either, but it would be worthwhile asking him or her.

HAWTHORN: I have been taking two large glasses of home-made hawthorn tea each day for a very long time. I have Atrial Fibrillation and am on a small (2.5mg) dose of warfarin. The sensation of heart flutters is completely eliminated by the hawthorn, true to its long history of success with circulatory problems.

I buy the raw herb and just cook up a handful in a small-ish pot, bring it to the boil, let it simmer for a few minutes then drink it either as a hot tea or as a hugely refreshing cold drink. (You can refrigerate for about 2 days.) Experiment with how strong you like it to be - like any tea. I drink a glass in the morning and take another to work in a drink container. Great stuff. (Btw, hawthorn pills don't seem to have the same effect on reducing the sensation of heart fluttering.)

I came off my coumadin that I have been taking for 6 months. About 1 month ago I felt tired, dizzy, blurred vision, depression, bitter mouth and I feel sick all the time. Are these side effects of being off coumadin? My breast is very tender as well. Also heavy breathing and leg pain.

I also see RED when looking at bright (mild)lights. I've been on warfarin for 2 years and this reaction started soon after I started. I see multiple red spots--mostly on skin on TV, light bulbs, etc.
Eye doctor said there was no physical reason. I can stop the spots by concentrating. Any others have a visual reaction?
Thank you.

as a dsw a client refused his Coumadin this morning as he stated “it tastes bitter”. How should I handle this? and what possible approaches should I take .

It says a lot that your dad has made it ok in a nursing facility for 1 1/2 years and has survived (in whatever state of health)... the taste issues and lethargy, could be the coumadin as it made me feel very gloomy and depressed. Seems the drug is a sometimes necessary evil, as it does the job, dissolving clots, however bad it makes one feel. Against my Dr's orders, I got off it about 10 months ago and gradually have felt more purposeful, the swelling in my feet is finally diminishing. A natural Dr gave me "Butcher's Broom" which has helped my eyes and circulation.

On the coumadin I didn't feel much like bathing or doing anything and felt depression (suppose that's what it was)I am 70 now and have always been optimistic except for the time on coumadin.

I found that the cinnamon, cayenne and other spices help the circulation along with some herbs. Too many leafy veggies (with vit K) seem to encourage clots. I think... keep reading, searching and overall balancing the diet with varieties of foods and spices is the best course. Lots of luck with your fathers health!

I have read thru most of these postings. I have been on coumadin since Dec of 2009 because of an embolus in the arm. I have many of the side effects that you people have, and until today, I thought myself 'lazy', and felt guilty about it. Now I know that it's the medicine......but it doesn't help the fact that yes, there is no replacement, other than natural supplements, but I don't dare go there......

In regards to the other new prescriptions for blood clot prevention, once I learned that there is no 'antidote' if needed, I was no longer interested. At least with coumadin we have vitamin K and plasma. Which I do wonder, why they wouldn't work with the new meds for blood clots also? I heard that from a triage nurse, so maybe, they too, do not want people to take the new medicine for their job would be at stake(no check ups). Is money really the bottom line then?

I have been on Warfarin for several years. Am bothered with the bruise stains I get on both arms. Is there any way the can be eliminated by massaging?

I am 42 years old and have been put back on coumadin after my second bout of pulmonary embolisms. The first round of treatment lasted for 6 months, and doctors determined my PE was caused by a road trip to Chicago. I was taken off of the coumadin in June of 2012 and after a few months went back to feeling close to normal. In January of 2013 out of the blue I started having shortness of breath and passed out twice, PE came back with a vengeance. I was told that my left lung was almost completely consumed with large clots and spreading fast to the right lung.

I am tired and sleepy all the time. I have also been told by doctors and nurses that those weren't side effects of the medication, but reading these posts lets me know I'm not crazy. I would gladly take coumadin every day for the rest of my days as long as I don't ever have to take another injection in my stomach. Fighting through the tiredness and sleepy feeling is the most difficult for me. I went from walking 4-5 days a week to not being able to walk up and down a flight of stairs without being winded.

Wishing everyone good health.

I have taken warfarin for many years for valve replacement & autoimmune disease. I'm interested in losing about 15-18 lbs with the help of garcinia cambogia extract. Will this product interfere with the blood thinner?

I look after an elderly lady who is on warfarin, I have been told that she should not sit in the sun while she is on the drug as it will harm her is this true? I would appreciate your advice thank you.

Hi I am travelling to Hawaii in July. I am on 7.5mg Coumadin daily. I live in New York would this be a problem?

Been on coumadin for a little over year now. On it for life. But I have been extremely tired and my mouth has been dry and sometimes mouth sores in inner bottom lip or tongue. I'm wondering now if this is side effect of this med... I have been tested to make sure nothing else is causing sore mouth and dry lips and they can't find anything. Could I be developing an allergy to this medicine now? Also seems mouth very sensitive to spicy food or sauces.

My husband has been on warfarin for 18mths how, he can not have any salt. But he has put on a lot of weight. We have made a lot of changes to our diet. But it isn't making any difference to the weight is the any sort of diets that he can go on to loss this weight. He is now 135kg. He was just on 100kg when he first got sick

I got blood clots during three of 15 surgeries? Was taken of twice and the third time kept on it for ten years. For nothing.... Too many doctors to many PTs, no communicating between the doctors is the problem. I had a kidney stone, blood in urine, blood blister twice hanging from my eye, severely hurt my leg, after two years still swollen, skin problems and extreme weight gain.

One doctor had me going for blood tests three times a week..... Have so much scar tissue in my arm, no blood can be taken without severe pain. And nobody cares what this has done to me. There should be one system where all the patient info can be found from all doctors that have been involved. This system works in Europe, why is America so careless?

(I found out, finally, from one doctor who told me I should only have been on Warfarin for six months, not ten years!) The reason why I am so furious, during a stomach surgery two nerves were cut, causing 20 years of pain and agony. The mistake was kept a secret by the doctor and hospital involved. As if the Warfarin mistake was not enough.

My dad is now 89. Due to heart problems he has been on warfarin and a pacemaker for at least 20 years. After some other health problems which he has nobly battled through, he has now been hit by a succession of stomach ulcers and has come off the warfarin after some of these ulcers became rather bloody and burst. Although the warfarin/pacemaker combo has presented heart problems have they led to the ulcers?

Coming off warfarin has probably led to some minor strokes. Which is now the biggest danger, ulcers from going hack on warfarin or more strokes from staying off warfarin?

Or should we just be happy he's got to 89?

I have been on Warfarin therapy for 1 month since I had bilateral PE. Also found to have hyper coagulation disorder. My problem is, I have extreme constipation, and bloating until I go 36 hours unable to eat. Later, this led to diarrhea, vomiting followed by extreme pain that turned out to be pancreatitis. Due to illness my INR was too high in hospital so they stopped warfarin 2 days and I got much better. Then they started back the warfarin and over the subsequent days the constipation has returned along with the bloating and complete loss of appetite. I think this drug may kill me...someone please advise me!!!

I was taking Lisinopril for blood pressure problems as well as Coumadin. I took the Lisinopril for several years with no problems. All of a sudden I began to cough and I was also having extensive bruising on my arms and legs. I checked with my doctors who both said my blood was "thin" and to stop taking the Lisinopril because one of the side effects was coughing.

Well, indeed it was! I ended up with a brain hemorrhage due to this combo. Weeks in the hospital where I was, of course, not taking either of the drugs. But now I'm finishing weeks of therapy at home and am also taking Coumadin once again before having a cardioversion to make my heart behave and go back into rhythm.

Sort of durned if you do, durned if you don't!

Billie

I got out of the hospital last week after a 3 day stay for shortness of breath, trouble swallowing, headaches, purple toes, and other symptoms. I was diagnosed with congestive heart failure, which then changed to sleep apnea. (not getting enough oxygen).

My actual problem was warfarin. I got off my regimen a bit while in the hospital and my symptoms started to diminish, although I didn't attribute it to a lower amount of warfarin. Later, when I went home, I delayed the wararin for 8 hours and then took only half my usual dose. All of my symptoms disappeared. I felt stronger and I had less fatigue.

There is some disagreement amongst doctors as to the test result (I won't give you the medical term) needing to be 2.0 - 2.5 or 2.5 to 3.5. I'm going with the 2.0 from now on.

Instead of taking cayenne pepper, garlic, fish oil, and vitamin E with my coumadin, I am going to add one at a time slowly to see if I can effect the test results. The I will add another, etc.

Hopefully, in time, I can take less warfarin. It is a dangerous, but effective drug. I have a titanium heart valve and have to take it, but I don't need to poison myself with it.

Trust my doctors? A little. Most of them can't define the simplest chemistry terms such as an ion, so I don't trust their pharmacological knowledge.

Ok here's one for you. I have been battling ongoing swelling from top of both legs to my toes since 2006. It was horrible couldn’t even walk from room to room. In 2009 I had first blood clot in lung after that was done and over I was on warfarin for about 5 months. Meanwhile though the swelling had calmed down the pain in my legs did not. I was extremely limited as to how long I was able to stand or walk and sitting was terrible as it caused immediate swelling in both legs, and feet and trying to stand after sitting was terrible was unable to sleep pain was non stop and muscle cramps would occur in both legs at the same time from top of thigh to the bottom of my feet, and lasted about 5min at which time you are unable to stand sit lay down. The pain is unlike anything I've ever felt, and occurred revery night with any amount of exertion and continued everyday until 2011 and another blood clot.

I hadn’t been on warfarin and I had lost insurance and hadn’t even been to any checkups. So now I'm on warfarin for life. But my legs are worthless and since 2006 the swelling has been so severe every day all day that shoe wearing and or even anything other then shorts have been a rough challenge. All of this and still no one can tell me why. Just recently I had some high blood pressure so am now on meds for that as well. 7 years of pain and no one knows why. To top it off for the last year I've had an infection that has been called cellulitus in one leg. But because of the excessive swelling it seemed to stay in a band just above the inside leg and ankle area. Poof after all these years all of a sudden because of the effects of this infection I have been unable to stay in an upright position for any amount of time which constant lying down during every day has finally release the horrible swelling but it also has unleashed the infection which is eating away at my leg and almost to my knee I've been hospitalized and treated numerous time nothing is helping, now the pain in my legs is worse then imaginable with the infection added in to the problem my foot is horribly discolored and usually pretty purple.

Every test done to me seems comes back basically clean. I have been unable to enjoy life for 7 long years and have only been able to work part time as my legs cause so much pain, and unable to be on my knees at all. So it has been 2 years since I've been unable to work at all and numerous dr.s with no answers I'm barely 52 now and life sucks anyone out there have any ideas please share! My life sucks. I did have an injury to the same leg years ago that took a very long time to heal but other then that I've had no other major issues! When this all started with the swelling in 2006. they cant even tell me why I had blood clots. Either time and have never seen them in leg MRI or ultrasound I have had many:)

I have been on 10 mg for a few years. Suddenly my INR goes from WNL to 9.1 in less than a month. I also have developed ortho static hypotension. I have also had two falls with severe bruising from the increased INR. I had a dose of vitamin k and was ordered to stop the Coumadin until further notice. Well the bruises continue. And have not been retested due to snow and ice.

I am concerned because 1) I have taken Coumadin for 28 years now 2) my last dvt was 2 1/2 months ago making 4 dvts to the legs and 3) I take Coumadin also for a-fib? What do I do? I haven't had any Coumadin in 6 days. Please give me advice!

I have been on Coumidin since December 2005 with a mechanical mitral vale. (Onyx) Can not tolerate warfarin but Coumadin 7.5mg daily maintains me
around 2.0 INR. But for the last two month I have been on a low carb diet with not sweets. Also, I have started exercising at gym and cardio 3 to 5 days a week to loose weight. Have been eating a lot more vegetables.

Since I have been on my diet my INR has varied even went to 3.9. I skipped a day and took half dose the next ant it went
down to 1.8mg .

QUESTION: WILL A LOW CARB DIET CAUSE INR TO INCREASE?

Hi, I had aortic valve replacement 2 years ago. My warfarin intake now is up to 10.5 mg a day along with Lipitor and 175 for thyroid. I am finding over the last 5 or 6 months that I am sleeping more than normal and when I wake I have no energy. Also I work rotating shift work at 13 hrs per shift nights or days. Also the bottom of my feet are tender all the time. I use to be a very active person, now my energy level makes it almost impossible to run. Wondering if anybody else has these symptoms? Thank you for any responses.

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