Al--Any validity to this article?

[Nancy]

Patients on Warfarin Advised Against Drinking Cranberry Juice

LONDON (Reuters Health) Sept 18 - British drug safety experts said on Thursday that patients taking the anti-clotting drug warfarin should limit or avoid drinking cranberry juice because of the risk of hemorrhage.

The Committee on Safety of Medicines said it had received five reports, including one where the patient died, suggesting the juice and drug interact, increasing the potency of the drug.

"Until this possible interaction between cranberry juice and warfarin has been investigated further, it would be prudent for patients taking warfarin to be advised to limit or avoid drinking cranberry juice," the committee said.

The fatal case involved a man whose international normalized ratio (INR) dramatically increased to more than 50 six weeks after starting to drink cranberry juice, it reported in its newsletter "Current Problems in Pharmacovigilance".

The man died from gastrointestinal and pericardial hemorrhage.

In two other cases, less dramatic INR increases were noted whilst patients were taking cranberry juice. In one of these the patient was stabilised on a lower dose of warfarin and in the other the INR returned to the therapeutic range after stopping cranberry juice," the report said.

According to the committee, the interaction is biologically plausible since cranberry juice contains antioxidants that inhibit cytochrome P450 activity, and warfarin is mainly metabolised by the P450 isoform CYP2C9.

Cranberry juice has boomed in popularity in recent years and is often used by women to prevent cystitis.

 

[LUVMyBirman]

Whoa. I have been drinking Cranberry juice on a regular basis. Test my INR weekly and have not noticed a change. Does not appear to effect me.

Now, pineapple juice does raise my INR without a doubt!

PS, Come to think of it...I drank almost an entire bottle over 12 hour period a few months ago.Ward off the start of a bladder infection. It worked wonders. Should be interesting to see what becomes of this release.

 

[EVELYN]

Hi G and Nancy

Tyce drinks cranberry juice, too.....So far no effects that we know of. Interesting article.

ev

 

[bvdr]

Gina,

Do you think fresh pinapple would do the same? I had the most delicious whole pineapple that I finished in two days and that would have been about 3 or 4 days before my INR of 6.1. I really can't think of what threw it off so much.

 

[LUVMyBirman]

Oh yes Betty. In high amounts. Also if you eat a lot of fruit and make it a meal for a few days your INR could go soaring. I find this to be true as was vacationing... and I love to eat those fresh fruit plates. My balance this time was a few salads. Worked great.

Ev, I love that juice! Please don't take that away too!

 

[bvdr]

Well Gina, that may well be it then. The ladies in my church prayer group brough me the most beautiful basket of fruit imaginable. For a long time fruit was the only thing that tasted great. I'll get my INR checked perhaps already Monday or Tuesday because with less warfarin and less fruit too it may plummet. I rather thought I had a green light with fruit but maybe I need to avoid anything in excess. Thanks for your help. I am really looking forward to meeting you in Chicago!

Nancy, my apologies for messing up your thread! Needless to say I found the article very interesting. Thanks.

 

[Nancy]

Re: the cranberry juice article above:

It's one of the juices that the hospital pushes, so I'll keep an eye out for any other info. on cranberry juice, because if it is a problem, then those going in for valve surgery, need to know about it, not to mention everyone else who is on Coumadin.

 

[Guest]

I saw this first on TV while I was eating lunch yesterday.

I thought, "What hokey thing will they come up with next."

15 minutes later I saw a guy with a 6.1 INR who said that his only change was that he started drinking cranberry juice.

Hard to believe.

Maybe this will explain some of those unexplainable fluctuations in the INR.

It should not have any effect on people who are already drinking cranberry juice regularly.

If you start drinking it or stop drinking it, it would probably be a good idea to get your INR checked in about a week.

 

[Creed3]

Hi!
I have been drinking various cranberry fruit blends for awhile now. My INR seems to have been pretty stable for months now. I don't have a home unit, so I don't know how it is from week to week. I get tested once a month. I would be very interested to hear if anything else comes up regarding cranberry juice and Coumadin. Thanks for the info.

Take Care!
Gail

 

[Nancy]

Well, it's just like anything else that we hear, we certainly don't know how often this patient had his tests, whether his doctor knew what he was doing with the dosages, or whether he was compliant with his dosages, nor do we know how much cranberry juice he was drinking.

 

[JimChicago]

Sounds similar to why they say you should avoid grapefruit juice. I hope it doesn't apply to orange juice. oranges, etc.

 

[JimChicago]

I wonder if this effect is similar:
http://www.ctds.info/vitamink.html
>>>>
A diet with high intakes of salicylates can block vitamin K. Salicylates are found in foods such as nuts, fruits, spices and mints. Aspirin is a salicylate. Blocking vitamin K is why aspirin can "thin" the blood - it basically keeps blood from coagulating. This is why too much aspirin can cause stomach and intestinal bleeding.
>>>>

To complicate matters it seeems like foods like nuts have some vitamin K in them but according to above article also contain ingredients that might raise INR?