Coumadin and beer

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greygoose

Member
Joined
Jan 25, 2012
Messages
7
Location
Michigan
Hello all, I am new to the site but not to heart surgery. A little info about me....

I am a recently married 28 year old male and I'm on my third aorta valve. The first two tissue valves failed prematurely. The first was a total mystery and the second was due to damage from endocarditis. So I finally broke down and allowed my surgeon to install a mechanical valve in. (the mechanical was installed 12/27/11)

My question is concerning alcohol and coumadin. My doctor told me that it was alright to start consuming alcohol again as part of my normal routine and we would monitor and adjust my medication accordingly. The only thing I'm having a hard time understanding is that even though I am having my beer or two (or three haha) a night after work they are still increasing my coumadin dose. I thought that alcohol was a blood thinner? So why would my dose have to increase? Any help understanding this would be greatly appreciated.

Thank you,

Goose
 
The beer is fine. Coumadine is an anticoagulant, not a “blood thinner”, in other words your blood viscosity does not change, just how fast you clot. At just a month out from surgery you may still be in the “find the right dose” period. I like the doctors stance on dose the diet not diet the dose.

Anyway remember with coumadin that all things in moderation should be fine.
 
My guess is that your INR isn't stable yet for reasons other than the beer. They will look at the number for the INR much more so than if you tell them that you have had more greens, more beer, less exercise, etc. I had a difficult time getting my INR into stable mode after surgery, but then for quite some time I was very stable. Recently I have had some instability, but that was/is due to changes on my own such as increasing exercise quite a bit in the last two weeks, and taking some trips which necessarily change your eating and exercise habits. Hope this helps.
 
Heavens, it took me 2 months to get my INR into range after my last surgery! We started where I had left off, but because I had dropped one diuretic that artificially raised my INR, my dosage which had been 28 per week before surgery went up to 36 per week after surgery. We went up slowly because I react wildly to changes.
Now I added that diuretic back in, and I'm back to 29 per week.
 
AgilityDog said:
Heavens, it took me 2 months to get my INR into range after my last surgery! We started where I had left off, but because I had dropped one diuretic that artificially raised my INR, my dosage which had been 28 per week before surgery went up to 36 per week after surgery. We went up slowly because I react wildly to changes.
Now I added that diuretic back in, and I'm back to 29 per week.
Click to expand...

Well, I guess I was just confused because when I was in the hospital my INR was at a 6 after just 2 days on a 10mg and 5mg dose. Then when i went home they did 2.5 then 5 every other day, then 5 every day, now 7.5 every day and it still isn't where they want it.
 
Shortly after my surgery, I asked a medical profession the beer question and received the answer that a bottle of beer is equivalent to 1/4 mg of coumadin. I wouldn't base any dosing on that, but it indicates that the couple beers a night has no real effect on INR. By the way, I started homebrewing after my surgery, and thoroughly enjoy that.
 
greygoose said:
Well, I guess I was just confused because when I was in the hospital my INR was at a 6 after just 2 days on a 10mg and 5mg dose. Then when i went home they did 2.5 then 5 every other day, then 5 every day, now 7.5 every day and it still isn't where they want it.
Click to expand...

There is NO standard dose of warfarin....it takes what it takes. Age, activity, habits, diet, etc.....etc will all play a part in your typical management dose.....and that will periodically change, although it should become reasonably consistant. I have been as hi as 70mg/wk as a young, active man and currently at 35mg/wk as an old man. It is not rocket science and, if you are like most people on warfarin, your dosage will level out. My personal key is reasonably (not rigidly) consistency in diet, activity, habits, etc.
 
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dick0236 said:
There is NO standard dose of warfarin....it takes what it takes. Age, activity, habits, diet, etc.....etc will all play a part in your typical management dose.....and that will periodically change, although it should become reasonably consistant. I have been as hi as 70mg/wk as a young, active man and currently at 35mg/wk as an old man. It is not rocket science and, if you are like most people on warfarin, your dosage will level out. My personal key is reasonably (not rigidly) consistency in diet, activity, habits, etc.
Click to expand...

Wow dick, you've had a mechanical valve and been on warafin for a long time! It's nice to see that people on these medications with valve replacement can live LONG happy lives.
 
JimL said:
Shortly after my surgery, I asked a medical profession the beer question and received the answer that a bottle of beer is equivalent to 1/4 mg of coumadin. I wouldn't base any dosing on that, but it indicates that the couple beers a night has no real effect on INR. By the way, I started homebrewing after my surgery, and thoroughly enjoy that.
Click to expand...

Mmmmmmm, home brew. I enjoy this myself.
 
So.. Has anyone tested the more than 3 beers theory on this medication? Maybe quite a few more? I'm no alcoholic, but I'd be lying if I didn't say I drank somewhat heavy once every couple weeks. I also have 3 weddings this late summer and fall and would live to get some insight on the matter. I'm also talking strictly beer, not liquor?
 
When I get a high INR reading the first question is, have you been drinking a lot. Not sure what a lot is but I think if you do any of the things that affect coumadin in large doses it will move your reading. Doing the same all the time and dosing to that, seems to be the key. Now that I am home testing weekly have been doing some experimenting with greens. How much I can eat without to much movement.
 
@Ovie, I have tested the more than 3 theory. I also liked to drink once in a while and when you hang out with a group who likes to drink it is not so easy to just give it up. At first it was super frustrating when you have your two beers and then you are done, while everyone else is just getting started. I have drank 8 several times. I have an INR home test kit and I tested when I got home from the party and I was at 4.5. When I woke up the next morning, my INR was back to normal. Needless to say that after having 8 on Coumadin, I felt like I had 12+ from before the surgery. I guess I have to say I don not recommend doing this but then again I do a lot of things the docs think I should not. I have mainly stuck to beer, nothing really harder than that. I have also tried to go the N/A beer route but it just tastes flat and makes me feel super bloated. I think I have just about tried everyone out there. I am 6'2", 250lbs so I kind of figured that the 2-3 beer limit is kind of general and has to have some kind of varience for the size of the people on the meds. Hope this helps.
 
It does help. I'm 6' 220, and can handle my beer quite well. The information I got from my cardiologist and surgeon was that it really wouldn't effect me, they were just more worried about something stupid happening to me while drunk ( hitting my head, falling, etc) that almost never happens, if ever when I stick to beer. Good to hear ill be able to have a few drinks with buddies every now and than. Thank you for the information.
 
I live at 8000 feet, outside of Denver, CO, and still enjoy beer as well. But now, after 2 or so, I'm stupid! Well, not that I'm any sort of rocket scientist before the surgery, but now it's worse.

I'm only 5'9", 195 (or so.... :D ) and don't really do the hard stuff (occasional rum and pepsi, some tuaca here and there) but if the warfarin isn't a blood thinner (I know the difference between the anti-coagulant and a thinner, I'm married to an RN, she tells me everything) then how is the alcohol so much more effective? Hell, it may even work out better for me. Last I was in Maui I could drink like a fish due to the altitude difference. Now it may be economically feasible for me to be down there.

But I'm still curious. If I were to drink a bunch of the harder stuff (I have a week long trip to Moab coming up in May) am I going to be FUBAR?

Allen
 
1,2,3,8 or no beer, I have found the number of brewskies consumed has not effected my INR. A coworker is also a lifer on warfarin. He has the same result as me re consumption of beer and his INR. I'm certain others have found beer or no beer to effect their INR.
 
I've had 6 beers this week, my INR is still 2.1 so it doesn't seem to effect mine. Maybe if I had 6 on one night. I'm certainly not going to start drinking lots on a frequent basis but as I've been told to keep my INR below 2.5 I will not be too concerned about drinking a few here and there. One thing to point out is that alcohol will effect your INR depending on if you are eating at the same time etc. if you are eating a big meal with a a bottle of wine it is less likely to impact INR than a bottle of wine on its own. Common sense really. And also, many people may drink more than they should and be fine. They may be out of range with INRs over 5 and be fine. But remember, every time you are out of range you are increasing the risk of an adverse event. Another reason why home monitoring is so important. It is much easier to see what effects your INR levels and over time you will know exactly to what extent things interact with warfarin.
 
There are chemicals in some red wines that can have an effect on INR. The whites and most of the roses probably don't have enough to raise your INR significantly -- although if you drink ENOUGH, your likelihood of walking into something or falling down may put you at risk of bleeding or bruising when you make contact what that nasty floor. I'm not sure about beer making a difference in INRs.

As far as getting FUBAR - if you drink enough, it can certainly happen although, as noted, at higher altitudes, the alcohol (whether in beer or wine or harder stuff) will probably mess you up more quickly.

And, also as suggested by markp66, having a meter would be a good idea if you have any doubts that you want to test for.
 
I definitely tested the three beers theory when I was 21. I partied like all other 21 year olds in my small town. However, I never got my INR drawn immediately after drinking, as home testing wasn't available then, and I still dont home test now. When I would go get my INR drawn when it was time a week or two later, I never had a problem. i've been on this med since 2 years old, so I tested the drinking theory a lot.
 
I am not ready to drink yet but intend to study the effects with extensive home testing once I am ready.

I touched the topic earlier and most comments are to be consistent but that is not what I want. Having to drink on a daily basis, to be able to also drink on the few occasions you really want it does not seem right. I used to be a binge drinker and get real drunk on some occasions. I realize that this will probably not be possible anymore, then again...consuming alcohol less often and in smaller quantities will probably result in me getting drunk very easily.

I got some information from the nurse in my warfarin clinic. She told me that the INR goes up pretty much directly when consuming alcohol and gets back to normal when the alcohol is out of the blood stream (I guess that is within 24 hours). I think that people who (binge) drink and only test every few weeks or monthly don’t see the effect for this reason.

The fact that it only temporarily raises the INR makes me think that there is not a real way you can manage a binge drinking session by changing your warfarin intake. It seems to me though that there is less risk in having an out of range (too high) INR just for a short while than for a longer time.

I can imagine that when you are in the bottom of your therapeutic range (2.0-2.5) and drink quite bit your INR may temporarily shoot up to 4.0 or something. This is too high but maybe not extremely dangerous. The big question is however how many beers will increase you INR by how many points. I intend to test this by home testing and I will post the results. I hope once I have this information I will again be able to have my fun nights out. I would always test before a session and still try to keep the alcohol intake within reasonable limits.

I told my plan to my warfarin nurse, she kind of understood and smiled. What I understand from her is that she has seen people completely drunk and that the INR still wasn’t extremely out of range.
I said: "If my INR is low like for example 2.0 at start and I drink 8 beers maybe my INR will only go up to 4.0 or something".
Her answer: "Maybe it will be less". Anyway something to test and find out for myself.......

Will keep everyone informed.....
 
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