Coumadin & Vytorin

[rwsp768]

Approximately a month and half ago I was placed on Vytorin 10/20 and everything was just fine. Last week was in for my INR check and it had shot up to 3.7. I have been holding steady for the last eight months at 2.4-2.8. Doctor doesn't seem to know if the Vytorin is the culprit, which I think it is, as I haven't changed anything in my diet. Just wondering if any others have had this problem with statin drugs and Coumadin as this is the first statin that hasn't torn me up in someway. I realize that this isn't a big jump, but it still bothered me. So now he had me cut my Coumadin for three days to 2.5mgs. Before I was six days at 5mgs and one day at 2.5mgs, also I have eaten some salads the past three days that contain vitamin K. Will be going back later this week for another INR check.

 

[Ross]

Vytorin contains SIMVASTATIN. There aren't a wide array of reports, but some would lead one to believe that it is entirely possible.

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

 

[Guest]

Shot up does not apply to anything under about 7.

I would be hard pressed to think of a reason to reduce the dose for someone whose INR was 3.7.

The person managing your warfarin either does not understand it very well or overreacts to tiny bits outside the range,

Would this operson think of slamming on the brakes if they discovered that they were doing 37 in a 35 zone? That is how inconsequential this change is and why shot up should never be used with INRs that start with 3. (Unless you had only been on warfarin for one day and the INR was 3 - that would qualify as shot up.)

 

[fyrfytr]

Hey rwsp768
I have been on Vytorin 10/40 for 5 months now and have not noticed any problems with my INR. I always try and stay on the high side, have been around 3.4. I am with Al and would not reduce my dose for a 3.7 reading.

 

[Karlynn]

What Al said!

Just as an FYI the doctor reduced your weekly dose by 15%.

My guess is that if you do the dosage reduction your doctor wants, you may go below range.

My range is 2.5-3.5. A month ago at my 6 mo check up, my cardio's machine tested me at 4.8. She and I agreed to make no changes to my dose and test in a week. With heat and travel my INR has been as low as 3.2 since then, and today it was 4. And I'm still on the same dose. It took me a long time to not make myself crazy by thinking I had to strictly adhere to my range and to not make adjustments all the time to stay tightly in that range.

 

[Christine]

I agree with everyone else.. I too take vytorin 10/40 and can't say for sure if it causes my spikes.. but I don't worry anymore or do any dose changes unless I go obove 4 or 5 consistantly, meaning, I test every other week unless really high or low (under 2 or above 6).. also like most, I self test and self dose..

chris

 

[Mary]

Shot up does not apply to anything under about 7.

I would be hard pressed to think of a reason to reduce the dose for someone whose INR was 3.7.

The person managing your warfarin either does not understand it very well or overreacts to tiny bits outside the range,

Would this operson think of slamming on the brakes if they discovered that they were doing 37 in a 35 zone? That is how inconsequential this change is and why shot up should never be used with INRs that start with 3. (Unless you had only been on warfarin for one day and the INR was 3 - that would qualify as shot up.)

My MIL is on coumadin for a-fib. I asked her the last time we visited, what they wanted her INR range to be. She said no one had ever mentioned it. So last night she called and before she hung up, said, "By the way, I asked and they want me to stay between 2.0-3.0." I thought, Well that sounded reasonable.
Then she said that two weeks ago, when it was drawn, it was 2.1 and they considered that "perfect". Yesterday, it was 3.0 and they considered that high so they were tweaking her dose. She had been on 5 mg daily, and they want her to try 5mg, 4 days a week and 4 mg the other 3. I figured that was pretty conservative (35 down to 32), but still, why would they try to make any changes? I would be happier with 3 than 2.1, and why are they testing every week?
Anyway, I thought about this when I read Al's reply. And Al, in your opinion, who is at greater risk for a clot--mechanical valvers or people in constant afib? Valvers is my guess, but I thought I would ask for sure.

 

[Guest]

Mitral valvers for sure, then aortic valves and then a -fib -- assuming all else is equal.

 

[rwsp768]

Coumadin & vytorin

Coumadin & vytorin

Thanks for the reply. Al I forgot to mention that I have a huge bruise on my calf that I have no way of knowing where it came from. This thing is a good 5 inches long and 3 inches across. The first few days it was hard as a rock, and that worried me along with the spike to 3.7

 

[Guest]

I don't know why but bruises with a hard spot are fairly common among warfarin takers. They take longer to dissolve than a regular bruise but other than that seem to cause no harm. I probably see about one per week.

 

[rwsp768]

Hey Al I had a bleed this morning. Was getting ready for work and suddenly got a nose bleed for no apparent reason. So just maybe my metabolism is different than the average person.

 

[Guest]

Around here we blame them on high altitude and the dry air, but I guess you can rule that out in Olympia.

I doubt that it is your metabolism that is off. Are you also taking aspirin or Plavix (clopidogrel)? They increase your risk of bleeding with warfarin.

 

[StretchL]

Wow...

Wow...

I was just looking into this issue earlier today, and came online to see if there was anything here about it. This site says that Vytorin does, indeed, effect warfarin: http://www.drugs.com/vytorin.html

 

[Guest]

It probably causes a small but statistically significant change in the INR that does not cause a significant change in what actually happens to people.

 

[rwsp768]

Went back in on 8/25/06 and had another INR check. It had came down to 2.0 just where the doctor wants me. As far as the nose bleed, they want to keep a eye on it, should it keep happening, then he talked about cauterizing it, and yes I take 81mgs of baby aspirin every day along with the coumadin an pepcid.