drug/health supplements and warfarin interaction

[skrob49]

With advice from forum users about "Dosing the diet", I think i am pretty confident of planning a diet. However, drug interaction seems scary - looks like half the drugs potentiate and the other half reduces the effects of warfarin, so we have an infection, we are in trouble?? Again, for the elderly, we would like to supplement with say CoQ10 or Omega 3, we face similar trouble.
Seems a case of "damn if we do and damn if we don't??

 

[dick0236]

With advice from forum users about "Dosing the diet", I think i am pretty confident of planning a diet. However, drug interaction seems scary - looks like half the drugs potentiate and the other half reduces the effects of warfarin, so we have an infection, we are in trouble?? Again, for the elderly, we would like to supplement with say CoQ10 or Omega 3, we face similar trouble.
Seems a case of "damn if we do and damn if we don't??

In my past, there have been many occasions when I have had to use antibiotics to fight or prevent infections. Some seem to have an effect on INR, others have not. Some have required a small change in warfarin, but others have not. The effect of anti-biotic has always(as I recall) been minimal and of short duration and has never posed any problem. I have used both CoQ10 and fish oil(Omega 3?) in the past and don't remember if they caused an INR adjustment. Frequently, the addition of long term maintenance drugs or supplements will cause a "permanent" change in warfarin dosage. This normally is not a big deal....you just add or subtract warfarin too compensate.

One of the things that surprised me, when I joined this forum, was the level of unusual and unnecessary fear about taking warfarin. Non-compliance in "taking and testing" should be the bigger concern. When I was young and "bulletproof", I was non-compliant....and consequently, suffered a stroke. After that "wake-up call", I learned to "take and test" and have not had any problems for 36+ years. My own experience is that I can do:cool2:, eat:biggrin2: or drink:angel: anything I like...so long as I "take and test":thumbup:.

 

[ALCapshaw2]

My Cardio recommends no more than 1000 iu of Fish Oil and prefers not to recommend Vitamin E or CoQ10.
Some Cardios seem to be OK with taking the "minimum daily allowance" of vitamins and minerals.
Check with Your Cardio!

'AL Capshaw'

 

[Protimenow]

The issue with "take and test" is that some supplements or foods may have a more rapid effect on INR than changes in warfarin dosage. If the food or supplement has effects on Vitamin K (if it contains K, for example), the effects will probably not be immediate - just as warfarin's effects aren't. However, if what you're taking works on other parts of the clotting systems - perhaps influencing platelet formation or something like that, the results may be a lot more immediate, and you may not want to wait more than a day to test. I don't think there's a comprehensive source of information about interactions or the effects of certain things you eat, swallow, etc., with warfarin - it would be good if there was (even if this forum has some anecdotal stuff like 'I took XXX and it raised my INR', just to give us something to confirm from our own experiences).

I took some penicillin for a sore throat for a few days (I don't really want endocarditis), and had some romaine lettuce in my burritos for a few days, and it's been more than a week since my last test - so because of these two things - which I don't expect to change my INR - I'll be testing JUST TO BE SURE that my INR is still in range. (If, at some time in the future, I take Cod Liver Oil every night, like my wife does, I'll do some more frequent testing (a day or two after I start with the fish oil) to be sure that any changes it may cause have been controlled by slight dosage adjustments -- then I'll go back to weekly or bi-weekly testing once I am confident that I've dosed the new diet).

 

[Cris N]

The best advice I can give is to do the research yourself - before ingesting the supplement. This was my entry in the Outrageous Advice thread:

I went to a chiropractor yesterday. So, I get there, fill out all the paperwork including a list of medications I'm taking - warfarin being at the top of the list. Because I'm still experiencing some significant incision pain, he recommended some enzymes to help reduce the inflammation. His words to me were, "This won't interfere with your warfarin." So, I buy the stuff ($32.86). Normal dosage is 2 pills, but because he wants to get the inflammation down, he tells me to take 20 pills each day for 2 days & then 10 pills for 3 more days. So, taking him at his word that it was safe, I downed all 20 pills. Then I decided to research the ingredients. The first place I went was to Al's site... there I found that one of the major ingredients, Papain, was on the no-no list. Looked at a few other trusted health sites, Papain on the no-no list. Can cause uncontrollable bleeding! May interfere with INR. Went to the manufacturer's site. It said that this supplement should probably not be used on patient taking warfarin.

So, in your wife's case you might want to Google "warfarin and CoQ10"

Don't read just one entry, though, look at a lot of them. Except for Dr. Gourmet. He's nuts.