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Coumadin Interactions Pose Dangers

Q. Does aspartame affect bleeding if you are taking a blood thinner like Coumadin? I know that cranberry juice poses a potential problem with this drug. How can I keep up with Coumadin interactions?

A. Coumadin (warfarin) is a life-saving drug but it can be tricky to use. This medicine reduces the risk of blood clots that can lead to strokes or heart attacks. Getting the dose right, however, poses a significant challenge. Too much or too little drug can be dangerous.

Many foods and other medications can interact with Coumadin. When a person taking Coumadin drinks a lot of cranberry juice, the risk of dangerous bleeding may rise. Several cases have been reported, but scientists are still debating the clinical significance of the interaction.

Aspartame (Equal, Nutrasweet) is an artificial sweetener that may increase bleeding time (Clinical Pharmacology and Therapeutics, Feb. and May, 1998). Although this interaction is controversial, we would encourage anyone consuming aspartame and taking Coumadin to monitor the impact on bleeding very carefully.

Sorting out all the dangerous food and drug combinations with warfarin is complicated. Our free Guide to Coumadin Interactions is available at www.peoplespharmacy.com.

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies..
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