How do you feel about Coumadin (Warfarin)

[Bina]

Coumadin is no big deal for me. Just one more pill. (at least so far)

 

[scapel]

I'm a 71 y/o retired Surgeon that had a triple bypass and aortic valve replacement 8 weeks ago. I will only have to take the Coumadin for about another month.
I wonder what the symptoms will be if I have a failing xenograft. (pig).
Probably and outflow obstruction and heart failure symptoms. Maybe the pig will last to the end of my life.
I have been refraining from eating green leafy vegetables as per recommendations and from limiting alcohol intake while on Coumadin. I think this veggie thing must be Vit K thing, but one would have to eat a lot of lettuce for enough vit K to change the PT
My wife is making me jump through all these hoops. I don't think artificial valve people would follow these strict rules for the rest of their life. No cranberry juice?
Anyone have any comments?

 

[Ross]

I'm a 71 y/o retired Surgeon that had a triple bypass and aortic valve replacement 8 weeks ago. I will only have to take the Coumadin for about another month.
I wonder what the symptoms will be if I have a failing xenograft. (pig).
Probably and outflow obstruction and heart failure symptoms. Maybe the pig will last to the end of my life.
I have been refraining from eating green leafy vegetables as per recommendations and from limiting alcohol intake while on Coumadin. I think this veggie thing must be Vit K thing, but one would have to eat a lot of lettuce for enough vit K to change the PT
My wife is making me jump through all these hoops. I don't think artificial valve people would follow these strict rules for the rest of their life. No cranberry juice?
Anyone have any comments?

Scapel your falling for a bunch of garbage. We have a saying around here, Dose the diet that you eat, don't diet the dose of Coumadin that your on. Your body needs greens and there is no reason on earth not to eat them as you always did before. Coumadin can be adjusted for the diet. This is another one of the gigantic myths still in some Coumadin managers minds.

Cranberry juice is fine also, just don't sit down with a few gallons and start chugging. A glass a day is not going to cause any problems. Alcohol is not encouraged, but you can still have a couple if you want too. Moderation is the key. Now if your prone to ulcers, then by all means, stay away from the alcohol.


We don't follow strict rules because we've seen the light. Most of us are self testing and self dosing. We got tired of being poked and told a bunch of stories from the golden era of old when testing was take the med until you bleed then back off a bit.

See www.warfarinfo.com and learn the modern way of things.

 

[Rain]

Bored Ross?

Bored Ross?

You getting a little bored this summer, Ross? lol I can’t believe you brought this sleeping dog back to life. And he wasn’t even in the flower bed!!

Scapel, I live my life just as I did before I started taking coumadin 8.5 years ago. My biggest compliant of warfarin right now is the bruises on my legs. It’s summer time here in Colorado.. and I wear shorts in the summer time. I’ve noticed I have ten times as many bruises and they’re twice as big. Also.. the garden is producing.... and I do love those green leafy veggies.. I eat them daily... and require warfarin adjustments to match the intake.

I wonder if you are thinking of grapefruit juice.. I don’t think there is anything wrong with cranberry.

 

[Ross]

The cranberry thing has no substance to it. It was spawned by some screwy study....Well I'll find and post the thing.

UPDATES:
http://www.warfarinfo.com/cranberry.htm

A study by Lilija et al found that cranberry juice had no effect on the enzymes responsible for the metabolism of warfarin, therefore it is very unlikely that any interaction occurs. Drinking cranberry juice daily caused no effect on the action of warfarin.

A study by Mohammed et al. found that when a person was pre-treated with cranberry and then given a dose of 25 mg of warfarin that the area under the INR-Time curve was increased by 30% compared to the warfarin dose alone. There are two enzyme systems that are affected by warfarin; the VKORC1 (the site where warfarin affects the slowing of the activity of vitamin K), and CYP450-2C9 (the site where the body rids itself of warfarin). Most studies have been associated with the -2C9 system. However, more knowledge is being gained about the VKORC1 system and it appeared from this study that this was the site involved. This would explain much of the controversy over whether or not there is an interaction.

References

Committee on Safety of Medicines. Possible interaction between warfarin and cranberry juice. Current Problems in Pharmacovigilance 2003;29(Sept)8.
Committee on Safety of Medicines. Interaction between warfarin and cranberry juice: new advice. Current Problems in Pharmacovigilance 2004:30(Oct)10.
Greenblatt D. Cranberry juice and warfarin: Is there an interaction? Anticoagulation Forum 2006;10(Spring)1-4.
Greenblatt D, vonMoltke L, Perloff E, Luo Y, Harmatz J, and Zinny M. Interaction of flurbiprofen with cranberry juice, grape juice, tea, and fluconazole: in vitro and clinical studies. Clinical Pharmacology and Therapeutics 2006;79;125-133.
Rindone J and Murphy T. Warfarin-cranberry juice interaction resulting in profound hypoprothrombinemia and bleeding. American Journal of Therapeutics 2006 May-Jun;13(3):283-284.
Lilija JJ et al. Effects of Daily Ingestion of Cranberry Juice on the Pharmacokinetics of Warfarin, Tizanidine, and Midazolam-Probes of CYP2C9, CYP1A2, and CYP3A4. Clin Pharmacol Ther. 2007 Mar 28; Epub ahead of print.
Mohammed AMI et al. Pharmacodynamic interaction of warfarin with cranberry but not with garlic in healthy subjects. Br J Pharmacol. 2008 Jun 2. [Epub ahead of print


Grapefruit juice...I even drink it, but not until at least 4 hours after taking the Coumadin. Don't drink it at the same time as taking the med. If your on other meds, then I wouldn't advise it. Grapefruit juice can cause problems with alot of meds. http://www.warfarinfo.com/grapefruit-juice.htm

 

[Bina]

I live as my father taught me: "Everything in moderation"

 

[Rain]

Grapefruit juice..

Grapefruit juice..

And don't take my word for it about the grapefruit juice... I just remember reading about it somewhere. I'm not a big fan of grapefruit juice anyway.. so no biggie for me.

 

[Ross]

And don't take my word for it about the grapefruit juice... I just remember reading about it somewhere. I'm not a big fan of grapefruit juice anyway.. so no biggie for me.

No your right, it interacts with so many meds in bad ways, that it's best to leave it be, but I drink it from time to time and haven't had problems, but see Al's list of drugs that don't play nice with it.

 

[Ross]

I closed this poll and will create a new one. Seems I have a person not on Coumadin voting and skewing the results.

 

[Nancy]

Joe was on Coumadin for many, many years, and it wasn't leafy green veggies that caused problems with INR, it was medication interference with the mechanism of the Coumadin action, and also his own medical problems. CHF(congestive heart failure) was one of the things that caused the most trouble with INR, first when he was in CHF and then when he had to take extra diuretics to get rid of it. ALWAYS caused ying and yang problems.

People with ascites CHF have especially difficult problems with INR levels.

Medication for hyperammonemia(Lactulose) caused problems.

There were also many other meds that caused problems.

I learned over the years of taking care of him that diet was a very minor player in INR level problems. Of course, Joe didn't pig out on greens, that would not be a good thing. But as long as things were in moderation, it was OK. Just eating a healthy, regular diet is the way to go.