Coumadin and Nexium

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ctyguy

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Joined
Feb 14, 2008
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Location
Columbus, Ohio
I was just given a scrib for Nexium but didn't get to call the Coumadin Clinic to let them know. I will call in the AM. Does anyone know if there is any concerns with Nexium having an effect on Coumadin ?
 
I checked the interaction list and didn't find Nexium.
However, if the side effects include diarrhea -- like with Prevacid and similar Rxes & OTCs -- then your INR might possibly increase. The drugs would affect the amount of naturally produced vitamin K in the gut.
 
Watch for a decreased INR. This was my experience. Good rule a thumb, test three days in and make adjustments if necessary.
 
Scott,
Based on my personal experience Nexium can have a VERY heavy impact on your INR. After beginning Nexium I had to decrease my weekly dosage of Coumadin by 20%. When I stopped using it earlier this year(after two and a half years on it), I had to increase my weekly dosage of Coumadin by a full 20%. So please keep an eye on it so you stay in a safe range.
Nexium is a good medication and cured the problem. I am aware of more than one person who ignored their problem and died from esophageal cancer.
But also be aware of the potential long term side effects of Nexium, it is a VERY long list.

Rich
 
AstraZeneca's prescribing info for Nexium claims that Nexium has no interaction with warfarin.

However, many who have taken a proton pump inhibitor Rx or OTC have found that their INRs do increase shortly after initiating treatment and they need to decrease their warfarin dosage.

This type of Rx does resolve a lot of problems with GERD, etc. Prevacid cured mine and I've had no recurrence.
 
I have taken Nexium for years (close to 8 or so) and started on Warafin in May, 2008. I am not sure that it has messed with my PT/INR at all. If it has, it has not been noticeable since I stay in the 2.5-3.5 range every 2 weeks. I have not had to have my warafin adjusted since July, so I am assuming that maybe my diet is really good and because I have been on Nexium for so long, it does not affect me like others (?).

On a different note, I finally have an appointment with the "Electrical" Cardio doc for Monday, Dec. 8th and he will decide how to handle my extra heartbeat as well as the rapid heartrate that continues!

Diana
AVR - May 16, 2008, Dayton Heart Hospital, Dayton, Ohio
Dr. John Miller
 
I would check your INR 3 to 4 days after starting it. There isn't supposed to be any reaction, but it appears everyone is different. I took Omeprazole or Prilosec and it didn't do a thing to me.
 
I've been on Nexium for over a year now, and it hasn't affected my INR at all. But like Ross said, everyone is different when it comes to how drugs affect them and their INR. LINDA
 
Scott,
Based on my personal experience Nexium can have a VERY heavy impact on your INR. After beginning Nexium I had to decrease my weekly dosage of Coumadin by 20%. When I stopped using it earlier this year(after two and a half years on it), I had to increase my weekly dosage of Coumadin by a full 20%. So please keep an eye on it so you stay in a safe range.
Nexium is a good medication and cured the problem. I am aware of more than one person who ignored their problem and died from esophageal cancer.
But also be aware of the potential long term side effects of Nexium, it is a VERY long list.

Rich

Rich,

Do you have a copy of that Long List?
or can you give us a Link?
 
Rich,

Do you have a copy of that Long List?
or can you give us a Link?

I'm not Rich, but here ya go:
http://www1.astrazeneca-us.com/pi/Nexium.pdf

As with all PPIs, patients treated concomitantly with warfarin may need to be monitored for increases in INR and prothrombin time. Like other PPIs, esomeprazole may interfere with the absorption of drugs where gastric pH is an important determinant of bioavailability (eg, ketoconazole, iron salts, and digoxin)
 
Al and Ross,
I havn't been around lately but that is the list I was referring to.
I also just received a letter from Astra Zeneca, offering me another discount on Nexium. In the letter received was another list of possible drug interactions, and the most important one they stressed was warfarin.
Maybe it doesn't affect everyone like it did me but we all should be aware of what could happen.
When I had all my problems earlier this year, I spoke to a pharmacist at Astra Zeneca. I was informed that they recommend using Nexium for four to eight weeks, or of course until the problem is cured. The longest long term study they have done is twelve months. Beyond that they really don't know what side effects may happen. That is why I traced down that long list of potential side effects. I do strongly believe the part about bloating and gas. Since I stopped using it my waist size has gone down a full two inches.
Rich
 
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