coumadin question

[CharlieBrown21]

I went and had my INR checked this AM and it was 1.5, down down from 2.06, my regular dose is 3-4 mg, she bumped me up to 5,5,4 for the weekend. We have been wondering what happened the last week and 1/2, my previous check went from 3.5 to 2.06. Does anyone know if taking liquid iron with coumadin will affect my INR?

Thanks

Ron

 

[Ross]

Short answer: Yes it sure will.

The minerals iron, magnesium and zinc may bind to warfarin and prevent its absorption.

 

[CharlieBrown21]

Thanks Ross, I was not sure

Ron

 

[KristyW]

THANK YOU, THANK YOU ROSS!!!

THANK YOU, THANK YOU ROSS!!!

Ross,

Thank you, thank you so much for the info on the iron. You just solved a mystery for me!!! I had been taking a 27mg iron tablet since I was discharged from the hospital almost 2 years ago. My cardiologist told me that I didn't need it anymore, so when I ran out, I didn't replace them. My INR was higher than normal at the next draw, but I didn't worry about it because it was only 3.1. About 2 weeks later, I ran out of my 1 A Day vitamins (no vit K, but 18mg iron), and I couldn't get to the store right away (Took about a week).

About 3 days later, I went into the hospital to with a kidney stone. When they tested my INR it was 8.9!!! I never knew why it went up like that until now. I couldn't connect anything to it.

So, thank you so much for solving my mystery.

 

[Lorraine]

Hi Ron,

Look at my post from 12/30/02 and 1/6/03. I was on Iron Pills for two months or so and my INR kept plummeting. Of course that meant playing with Coumadin dosage. Went off the Iron Tablets after they tested to make sure i didn't need it anymore, and my INR returned to normal range within the week.

Iron does indeed interfere with the absortion of Coumadin in my case. The only time my INR seems to be out of sync is if I take antibiotics or it appears sometimes the change in weather!

 

[Rain]

The dogs back in the flower bed!

The dogs back in the flower bed!

My multi-vitamin has 18mg of Iron, 100 mg of Magnesium and 15 mg of Zinc in it..... not to mention the 25mcg of K. Is that a bad thing?!

All the vitamins probably have some effect on our INR..... God knows, everything else does! So now are you guys gonna start watching your iron intake? Don?t most of the people here take some sort of a multi-vitamin? I hate the coumadin rat race!!

Hey, wait a minute!! Does the iron make your INR go UP or DOWN??!! Sounds like Ron?s went down..... Kristy?s went UP.

 

[Georgia]

ARGH-H-H-H

ARGH-H-H-H

WHY isn't this little pearl of information somewhere??? I've never seen any mention of this anywhere. Now I'm going to have to talk with my pcp (who's really not so good at monitoring my inr anyway); I never started taking my multi-vitamin after surgery because the one I was taking had Vit K and just never got around to finding another. And NOW I'll need to mess with my coumadin.

What's our mantra? "It's better than a clot . . . it's better than a clot . . ."

 

[KristyW]

Up - Down?

Up - Down?

Rain,

My INR went up after I stopped taking my vitamin. I'm took it that Ron's INR went down after he started taking iron. I could be wrong though.

What Ross wrote is about the only thing I've found about iron and warfarin (after much searching today). Iron binds to warfarin (along with some other minerals) and it interferes with the absorption of the warfarin by the liver. The recommendation is not to take the 2 medications within 2 hours of each other. I actually take them at opposite ends of the day, but you can see that there is still an effect.

Quote from GNC's SafetyChecker
http://www.gnc.com/health_notes/Drug/Warfarin.htm

Minerals
Iron, magnesium, and zinc may bind with warfarin, potentially decreasing their absorption and activity. People on warfarin therapy should take warfarin and iron/magnesium/zinc-containing products at least two hours apart.

What I'm going to do is remember not to run out of my vitamins. Other than that, I'm not going to worry too much about my iron intake. Basically I stopped taking all iron supplements within 3 weeks, and I hadn't check my INR after stopping. I have lowerd my warfarin dose by 5mg/week, and I'm doing ok now.

Hope this helps.

 

[Ross]

If you need vitamins, be consistent in the brand and content of what your taking so that the Coumadin can be regulated with the vitamin. I think we can all see what happens if you run out and don't have anymore right away.

 

[CharlieBrown21]

Thanks everybody, my INR went down taking liquid iron 44 mg 3-times a day Rain.

Ron

 

[Ross]

That seems like an awful lot of Iron. Was there some purpose for that much? 3x a day? Yowzers.

 

[Guest]

I had never heard of iron affecting the INR before and I couldn't find it anywhere. But I didn't want to appear dumb so I decided to sit back and see what other say. I guess you convinced me.

I've been telling people that it made no difference but I guess that it does.

I always try to remember that everything I know about warfarin, I learned from people who take it.

 

[CharlieBrown21]

Ross, I was taking the iron per my pcp's instructions, he said I was a little anemic.

Ron