coffeelover
Well-known member
Does anyone know if antibiotics will affect warfarin and cause a change in INR readings?
Antiobiotics and INR...
- Thread starter coffeelover
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For me, some affect INR and some don't. I've never had antibiotics have a significant or lasting effect. If you notice an INR change shortly after check, it will probably be the antibiotic. Normally I would not hold, or delay, an INR test because I was on antibiotics and I would test at your regular time. If you have an INR change, you can put that in your memory bank for the future.
pellicle
Professional Dingbat, Guru and Merkintologist
As dick says, test as normal, do not hold off testing, also do not change dose on the result of one test.
Even if you tested and found it was higher, how would you know that is not natural variance or a result of the ? You can't. Each reading in testing says little in itself, it is the trends in the record that say something.
I am taking antibiotics and my dose with them is the same as what my dose was without them. There may be some small change briefly, but just observe and keep a steady hand on the (dose change) tiller.
It you see a trend emerge (like higher than 3 for consecutive weeks) then consider dose adjustment. You can soon see why monthly testing is almost meaningless, it provides not enough data to see a trend.
Just go fishing and if you need antibiotics for some reason take them, just keep taking the warfarin as before. If they are a short course then there is no point in correcting for anything and if its a long course wait till you see a trend
Even if you tested and found it was higher, how would you know that is not natural variance or a result of the ? You can't. Each reading in testing says little in itself, it is the trends in the record that say something.
I am taking antibiotics and my dose with them is the same as what my dose was without them. There may be some small change briefly, but just observe and keep a steady hand on the (dose change) tiller.
It you see a trend emerge (like higher than 3 for consecutive weeks) then consider dose adjustment. You can soon see why monthly testing is almost meaningless, it provides not enough data to see a trend.
Just go fishing and if you need antibiotics for some reason take them, just keep taking the warfarin as before. If they are a short course then there is no point in correcting for anything and if its a long course wait till you see a trend
ncdrummer
New member
Mine has been high for two weeks straight because of taking an antibiotic. I suggest just work with your medical person who monitors your readings and manage it closely.
pellicle
Professional Dingbat, Guru and Merkintologist
Hi
Out of interest how much higher than usual?
ncdrummer;n857637 said:
Out of interest how much higher than usual?
Agreed
ncdrummer
New member
A full number higher actually.
pellicle
Professional Dingbat, Guru and Merkintologist
Hi
ok ... that's noticeable but probably not dangerous, I would want to see a trend over 2 weeks before I worried. Antibiotics do influence your Gut Flora and that can in turn change your metabolism and your INR. With respect to big changes however I've seen (SkiGirl here actually) someone go from 3 to 9 by drinking grapefruit juice
http://www.valvereplacement.org/foru...-python-moment
now that is a worrying change. But if you were to go from (say) 2.7 to 3.7 then I wouldn't get worked up about that at all. Personally (meaning if it were me) I'd perhaps reduce one of my doses by 50% and test again in a week ... but seriously it can be hard to pick that a change is attributed to the antibiotic without really looking into it. Its like saying my cold went away because I took Vitamin C ... it may have just gone away anyway.
For instance here is my 2014 data
you can see some spikes there which are attributed to me trying to fiddle with doses (INR on one scale dose on the other) and you can see that I actually did make it worse (but you know, I had to prove to myself that is what happens when you attempt to fiddle and why conventional wisdom is "steady hand on the tiller". Sometimes you go low and sometimes you go high ... its just how the body is (its not rock steady). You can see I went from (near the end of the year) from 3 to nearly 4 (and 2.7 the week before) with no changes what so ever.
If by conicidence I had taken something (like a new medicine) and had not been so dilligent with my records it would be easy to emotionally associate one with the other.
Stats may be boring in some ways, but when you look at your graphs and your stats you can know what's worrying and what's not.
For instance, here is some data from a large patient clinic study of INR and bleed event, you can see that INR has to go quite above 4 for there to be any noticeable change in events
which is why I would not be worried by moving up a number and why I would prefer to avoid a see saw in INR by adjusting something when there may not be a need. Much of the causes of problems in the past was that people were either measuring insufficiently (like monthly or less) or trying to over manage and causing see saws.
ncdrummer;n857643 said:
ok ... that's noticeable but probably not dangerous, I would want to see a trend over 2 weeks before I worried. Antibiotics do influence your Gut Flora and that can in turn change your metabolism and your INR. With respect to big changes however I've seen (SkiGirl here actually) someone go from 3 to 9 by drinking grapefruit juice
http://www.valvereplacement.org/foru...-python-moment
now that is a worrying change. But if you were to go from (say) 2.7 to 3.7 then I wouldn't get worked up about that at all. Personally (meaning if it were me) I'd perhaps reduce one of my doses by 50% and test again in a week ... but seriously it can be hard to pick that a change is attributed to the antibiotic without really looking into it. Its like saying my cold went away because I took Vitamin C ... it may have just gone away anyway.
For instance here is my 2014 data
you can see some spikes there which are attributed to me trying to fiddle with doses (INR on one scale dose on the other) and you can see that I actually did make it worse (but you know, I had to prove to myself that is what happens when you attempt to fiddle and why conventional wisdom is "steady hand on the tiller". Sometimes you go low and sometimes you go high ... its just how the body is (its not rock steady). You can see I went from (near the end of the year) from 3 to nearly 4 (and 2.7 the week before) with no changes what so ever.
If by conicidence I had taken something (like a new medicine) and had not been so dilligent with my records it would be easy to emotionally associate one with the other.
Stats may be boring in some ways, but when you look at your graphs and your stats you can know what's worrying and what's not.
For instance, here is some data from a large patient clinic study of INR and bleed event, you can see that INR has to go quite above 4 for there to be any noticeable change in events
which is why I would not be worried by moving up a number and why I would prefer to avoid a see saw in INR by adjusting something when there may not be a need. Much of the causes of problems in the past was that people were either measuring insufficiently (like monthly or less) or trying to over manage and causing see saws.
bocco
Well-known member
So I just tested 4.0 this morning in my self test training class.Couldn't think of a good reason for it. Then this post reminded me that I had my teeth cleaned yesterday and I took 200mg of amoxicylan before the cleaning. I wonder if that caused it?
bocco
Well-known member
So I just tested 4.0 this morning in my self test training class.Couldn't think of a good reason for it. Then this post reminded me that I had my teeth cleaned yesterday and I took 200mg of amoxicylan before the cleaning. I wonder if that caused it?
bocco;n857937 said:
It might.....but maybe not? I am currently having some dental work done and have taken 2000mg amox twice in Aug '15. Below are my INRs over that time:
8/5....3.5
8/12..3.0
8/19..3.7
8/26..3.8
That increase may be the result of the amox. The increase is not very significant but since I have two consecutive readings out of range(2.5-3.5) I am reducing my dose by 5%/wk. Just a "nudge" since I have one more dental visit next week that will require another 2000mg amox.
