coumadin and Azithromycin?

[perkicar]

Got put on a z-pack yesterday for an upper respiratory infection. It's azithromycin that you take for 5 days. Should I be worried about my INR during that time?
On a more entertaining note, I had a patient Friday whose INR had jumped up to 7.6; he was taking 5 mg daily for post DVT in his arm. They stopped his coumadin for 1 day he dropped to 2.1 the next day. Somehow I'm thinking the 7.6 was just a freaky number, I'm having a hard time trying to figure out how he dropped that much after missing one dose.....
Carolyn

 

[Ross]

Check your INR in 3 days. It should rise, but how much is the question. You may have to reduce your dose temporarily.

http://www.warfarinfo.com/azithromycin.htm

 

[perkicar]

Check your INR in 3 days. It should rise, but how much is the question. You may have to reduce your dose temporarily.

http://www.warfarinfo.com/azithromycin.htm

Thanks, dear! I'm feeling more human today although have started coughing some really foul looking stuff.....
Carolyn

 

[Ross]

Don't go gettin pneumonia now!

 

[perkicar]

Don't go gettin pneumonia now!

Oh no, don't want that at all!!! I thought this was allergies since its been mostly a tickly cough and then on Thursday, itchy ears, but when I started running a low grad fever I decided I shouldn't fool around anymore. You know us nurses, the last to take ourselves to the doctor. Turned out the doc I saw at my Primary Care's "Acute care" clinic was one the residents we worked with from MICU. Small world, huh!
I'm so proud of myself, I actually called in sick to work tomorrow. She gave me an inhaler too, since she said I sounded tight and wheezy. I kind of wish she'd done a chest xray too.....But I am going to stay home another day and let the antibiotics keep working.

 

[Guest]

Azithromycin is a tricky one. Because you only take it for five days but it stays in the body for another 5 days. If I can't monitor someone on it, I usually have them take 1/2 dose on days 2 & 4. This seems to prevent troubles. At least if the INR goes high, it doesn't get high enough for long enough to cause a problem.

 

[perkicar]

Azithromycin is a tricky one. Because you only take it for five days but it stays in the body for another 5 days. If I can't monitor someone on it, I usually have them take 1/2 dose on days 2 & 4. This seems to prevent troubles. At least if the INR goes high, it doesn't get high enough for long enough to cause a problem.

Thanks Al--tomorrow is the INR clinic at my cardiologist's. Should I go get checked then or wait until Friday when the next clinic is held? I'm due for a check anyway.
Carolyn

 

[Ross]

Yes get tested tomorrow. You'll be over by Friday.

 

[perkicar]

Yes get tested tomorrow. You'll be over by Friday.

thanks for the advice, mr ross! I will report back with my level after I go get tested tomorrow.
Carolyn

 

[Guest]

I Agree with Ross

 

[perkicar]

I Agree with Ross

I'm due anyway--I was going to go Friday but felt so crummy after getting home from the other doctor that I didn't feel like going downtown and getting tested. Since I'm taking tomorrow off (and feel better) I don't have any excuses.
Carolyn

 

[perkicar]

2.9 this morning

2.9 this morning

My INR was at 2.9 this morning. I'm going to go back in a week to get rechecked to make sure the antibiotic carryover doesn't take me high.
Carolyn