Concerns

[shenews]

I have my protimes checked monthly by my doctor. I have been taking warfarin 6 four times a week and 5 three times a week. Sunday, I noticed blood in my urine, and it increased greatly over the weekend. Monday, I went to my doc who checked my INA and it was 4.6 He stopped my warfarin for two days, and gave me Cipro for three days in case I have an infection in the kidney. I am also slated for CT scan of kidneys on Friday. He said warfarin can cause spontaneous bleeding, but said my INA wasn't high enough for that.
Anyone out there have any trouble with blood in the kidneys?
thanks for your input

 

[catwoman]

An INR of 4.6 isn't that high and warfarin certainly doesn't cause "spontaneous bleeding." It can affect the clotting time, but it's not going to CAUSE you to bleed.
What was your INR from the previous test? Was it in range?

Hematuria is not uncommon with warfarin patients. I've had it, but not that I could see. It was seen only in the lab.
You could have a tiny kidney or bladder stone or some other reason for the visible blood in the urine. Tests will determine that.

By holding 2 days' dosage, you may find that your INR will drop too much.
You're taking 39mg of warfarin a week. I would have reduced my dosage by 15% -- dropping 6mg overall weekly to see what that would do, retest in 4 days and then re-evaluate your game plan.

Let us know what the tests find out.

 

[shenews]

thank you, I will.
the blood in my urine is very visable.
My INA's have been around 3 for the most part.

 

[Ross]

Be careful, Cipro will cause your INR to rise, so maybe, for once, it was the right thing to do and hold a bit. Normally it would be unacceptable.

I'm betting on kidney or bladder infection.

WARFARIN SODIUM (in Coumadin Tablets) may interact with CIPROFLOXACIN (in Cipro)

Although the cause of this potential interaction is not clearly understood, ciprofloxacin may increase the anticoagulant effect of warfarin. Warfarin is generally used to prevent your blood from "coagulating" or forming blood clots. When ciprofloxacin and warfarin are used at the same time, your blood may be much less likely to clot and this may increase the risk of excessive bleeding. If these drugs are taken together, your doctor may want to monitor you closely when therapy with ciprofloxacin is either started or stopped. Blood tests can be used to make sure that you are getting the right amount of warfarin. If you are experiencing problems, it may be necessary to adjust the dose of warfarin. Your doctor may also consider switching to a drug that is similar to ciprofloxacin, but that is less likely to cause problems with warfarin. Ask your healthcare provider about these drugs and this potential interaction as soon as possible.

This interaction is well-documented and is considered major in severity.

Last Updated: February 2007

http://www.drugdigest.org/DD/Intera...&cD=151&cD=705&dN="Cipro"+"Coumadin+Tablets"+