How long for Coumadin to leave body?

[Ella4hubby]

Hello All,

My DH is now 3 months past Mitral Valve replacement (Porcine tissue valve) and is coming to the end of 3 months on Coumadin. The Cardiologist has cleared him to come off the Coumadin, and I am just wondering how long it will take for the Coumadin to leave my DH's body.

My main interest in this is that I would like to have him return to the vitamins & supplements he was taking before surgery and Coumadin - that were contra-indicated because of interaction with Coumadin. These include Vitamin E and fish oils which are known to have a blood thinning effect. As well some other vitamins were possible inhibitors to the Coumadin effect. Perhaps it is a moot point as DH is going off the Coumadin anyway but just thought it would be good for his body to be clear of it before introducing other supplements.

Checking online I've seen various statements - some saying 3-4 days and also saw a statement of 6-8 weeks....quite the range!

Anyone with information on this?

 

[dick0236]

I've never had reason to consider this, but the effect of warfarin(Coumadin) should be minimul after a week or so. You could do an INR test after a week and if he is close to 1.0(normal INR), that would indicate that warfarin has left his system.

 

[Ella4hubby]

I've never had reason to consider this, but the effect of warfarin(Coumadin) should be minimul after a week or so. You could do an INR test after a week and if he is close to 1.0(normal INR), that would indicate that warfarin has left his system.

Thanks dick0236. That is my impression. Was thinking my DH could up the greens this week to help the process along!

Not sure we want to do any more INR's...been a bit of a rough road trying to get the levels stable - lots of to and fro to the testing center - Doctor said it might take about 3 months to stabilize - and there you go, it's time to quit...And my DH is back to work full time so would be complicated.

Just want to say, if ever my DH had to be on the Coumadin permanently, we would definitely be looking into getting our own machine for home testing. That would simplify things greatly!

 

[pellicle]

Hi

as I understand it Warfarin has a half life of about 2 days. So at 2 days there is half what was there, at 4 days a quater 6 days down to an eighth and so on.

 

[pellicle]

things are more complex in the literature than I thought ... so I'll just leave this as "dick is on the money"

pardon my OCD posting

 

[Protimenow]

Personally, I wouldn't worry about supplements and warfarin. I can't imagine that your designated hitter (that IS what DH means, isn't it?) can wind up with an INR that is out of range because of fish oil, Vitamin E, etc. - they just don't seem to have that serious an effect. Also -- the half-life of warfarin IS around 2-3 days, from what I recall - so Pellicle is right -- after four days or so, the effect on the INR would be minimal. And, as others have suggested, adding some greens to the diet will also help to reduce the INR. And - if you're really concerned - low dose Vitamin K (included in many multi-vitamins, and available as a separate supplement), will reduce the effect of warfarin.

 

[Ella4hubby]

Hi

as I understand it Warfarin has a half life of about 2 days. So at 2 days there is half what was there, at 4 days a quater 6 days down to an eighth and so on.

Thanks pellicle. Appreciate the info. And no problem on the OCD posting. I always feel more info is better than not enough. Gives me stuff to work with.

 

[Ella4hubby]

Personally, I wouldn't worry about supplements and warfarin. I can't imagine that your designated hitter (that IS what DH means, isn't it?) can wind up with an INR that is out of range because of fish oil, Vitamin E, etc. - they just don't seem to have that serious an effect. Also -- the half-life of warfarin IS around 2-3 days, from what I recall - so Pellicle is right -- after four days or so, the effect on the INR would be minimal. And, as others have suggested, adding some greens to the diet will also help to reduce the INR. And - if you're really concerned - low dose Vitamin K (included in many multi-vitamins, and available as a separate supplement), will reduce the effect of warfarin.

Thanks Protimenow...appreciate your thoughts. The crazy thing is we were told categorically by the family doctor, and the pharmacist to avoid any vitamins at all because of either increasing the INR or at least increasing possibility of bleeding (not sure if it is by same effect as Coumadin), or that supplements could interfere with the effect of the Coumadin. I didn't completely obey as I had my husband take Vit C and B-complex...and no problem with the INR's. But I did decide to keep my DH (I mean Dear Husband but Designated Hitter sounds good too!!) off of any supplements with a known or suspected "blood thinning" effect, however weak or strong that might be.

There have been suspected cases of patients on Vitamin E and/or fish oil who ended up having hemorrhage problems during or after surgery and it appears that those supplements were the likely cause. Now the doses taken may have been high and that is what can make the difference. Not to say that that is always the case of A causing B, but hey, we decided to be safe rather than sorry. Having to go through this kind of surgery is pain enough, not to add having a complication of excess bleeding on top of it all!

Anyway good ideas...will add more greens following discontinuing the Coumadin. Don't think will worry about a Vitamin K supplement as this isn't an emergency to get the INR down...it will work its way down as you, Pellicle and dick0236 have said, in a matter of days to a week...

 

[pellicle]

Hi

The crazy thing is we were told categorically by the family doctor, and the pharmacist to avoid any vitamins at all because of either increasing the INR or at least increasing possibility of bleeding

its risk management ... they want zero risk that it will come back to them ...

(not sure if it is by same effect as Coumadin),

I am uncertain what you mean, but Coumadin, Marevan and some others are tradenames for Warfarin.

A good basic start on the topic can be had here... http://en.wikipedia.org/wiki/Warfarin

although it has some holes which do not match with high quality pharmacological data sources

 

[Protimenow]

For years, I avoided Vitamin E. I've taken it, and had no noticeable change in my INR.

I usually forget my multivitamins -- for weeks that I remember - or that my DW (you can figure that one out) lays out a day's worth of supplements, I make sure that my INR remains in range. I test weekly - regardless of whether or not I've made any changes. A lot of the warnings from the medical/pharmaceutical professions seem to be more CYA than anything else.

If DH is off warfarin, that's good for him. His INR should drop fairly quickly - especially with the greens that you're giving him. Don't avoid vitamins with K in them - K1 and K2 have been shown to have beneficial effects beyond their influence on clotting.

 

[Ella4hubby]

For years, I avoided Vitamin E. I've taken it, and had no noticeable change in my INR.

I usually forget my multivitamins -- for weeks that I remember - or that my DW (you can figure that one out) lays out a day's worth of supplements, I make sure that my INR remains in range. I test weekly - regardless of whether or not I've made any changes. A lot of the warnings from the medical/pharmaceutical professions seem to be more CYA than anything else.

If DH is off warfarin, that's good for him. His INR should drop fairly quickly - especially with the greens that you're giving him. Don't avoid vitamins with K in them - K1 and K2 have been shown to have beneficial effects beyond their influence on clotting.

Thanks Protimenow. Yes I think sometimes it may be case of covering themselves as you say, but also I think many health professionals are not familiar with supplements and their proper use. I was trained as an RN (registered nurse) many years ago and am familiar with the basic training given. It was not until I became quite ill myself with serious Thyroid problems that I realized how standard medicine had no real answers for me. I had to look into alternative health sources and learned that there were lots of safe and effective options available to me. If it weren't for supplements and some practitioners who were unafraid to work outside the box, prescribing for me an "old-fashioned" medication no longer widely used, I would be bedridden and pretty much non-functional at this point.

Sorry, I jumped on my soap-box there for a minute! I just get so frustrated with the narrow-minded thinking of the medical community (of which I was a part) that often leaves people with less than optimal care. OK, I'm done!

Oh, and as to your recommendation of the Vitamin K's -- I just meant that I wasn't going to run out and buy a multi-vitamin supplement with Vit K in order to speed this process along. I do agree that we need the Vitamin K's and all through this Coumadin treatment time, I tried to make sure my DH was eating a regular amount of greens - as per general instructions.

 

[Ella4hubby]

Well, thank-you to all who have chimed in here. Tonight is my DH's last dose of Coumadin so we'll up the greens for the next several days and sometime next week we wil re-start the supplements he was on previously.

I really do appreciate this forum - not sure how others go through this kind of surgery and all the before, during and after stuff, without some kind of support. I had no idea about any of this before being thrust into this adventure, and this forum has been a life-saver for me and my husband many a time!

 

[Protimenow]

A lot of us here had to go through the whole 'you need heart surgery' thing with minimal support. My surgery (1991) was before the Internet started to do anything, Dick (1967?) is one of the pioneers with an early valve in his chest, and for many of us, it was just kind of blundering in the dark, and hoping that we survived - and that our doctors knew just what the hell they were doing.

As far as this soapbox -- I'm probably more guilty than many others of using these forums as a soapbox for opinions, to reflect desires, etc. I don't think there's much wrong with speaking out a bit. In my case, I try to make it clear that the opinions are mine - and that any risks that may be taken because I've followed my own advice - are personal risks that don't have to be repeated.

Your discussion about the medical community appears to be extremely valid. I have a relative who is a new LVN (Licensed Vocational Nurse), who was indoctrinated with the belief that the only good medicine is modern medicine; that any pill that has gone beyond its expiration date must be either unsafe, ineffective or toxic; and that her relatives should no longer be treated as relatives -- instead, they're potential 'patients.' I take a few supplements -- and I'm not uncomfortable with the idea of using these minerals or other things beyond their 'expiration' dates. Does Zinc stop being Zinc after a date on the bottle says so? I don't think so. Does Vitamin C become something else after a magical date on the bottle? I doubt it. I'm sure that expiration dates are valid for some medications -- the potencies may decline; perhaps some chemical reactions occurring in the materials may render them less effective (and, in some cases, possibly dangerous), but for the majority of supplements, I suspect that, for the manufacturers, expiration dates accomplish two purposes: it shields the manufacturer against any claims that a medication caused damage ('you took an expired medication') and also helps to sell more.

I'm sure that I'll be getting contrary opinion from some pharmacists or others about how wrong this thinking is -- but in many cases, I suspect that many 'expired' medications (with the exception, absolutely, for antibiotics that require refrigeration and other medications requiring special handling) are still good long after the expiration date.

(In my case, I was using some OTC medications that were near or past their expiration dates for financial reasons. I'm not sure how effective any of these were - either before or after expiration dates - but I don't think that there was much change from before to after the expiration date. Now that I'm able to buy these things a bit fresher, I often don't, partially out of habit and partially because it didn't seem to make any difference whether or not the OTC was expired).

Now - excuse me while I jump off my soapbox.

(I know that this probably should be in a new thread - I'm responding to your comments about how traditional medicine failed you -- as it does many others, including my DW)

 

[Ella4hubby]

A lot of us here had to go through the whole 'you need heart surgery' thing with minimal support. My surgery (1991) was before the Internet started to do anything, Dick (1967?) is one of the pioneers with an early valve in his chest, and for many of us, it was just kind of blundering in the dark, and hoping that we survived - and that our doctors knew just what the hell they were doing.

As far as this soapbox -- I'm probably more guilty than many others of using these forums as a soapbox for opinions, to reflect desires, etc. I don't think there's much wrong with speaking out a bit. In my case, I try to make it clear that the opinions are mine - and that any risks that may be taken because I've followed my own advice - are personal risks that don't have to be repeated.

Your discussion about the medical community appears to be extremely valid. I have a relative who is a new LVN (Licensed Vocational Nurse), who was indoctrinated with the belief that the only good medicine is modern medicine; that any pill that has gone beyond its expiration date must be either unsafe, ineffective or toxic; and that her relatives should no longer be treated as relatives -- instead, they're potential 'patients.' I take a few supplements -- and I'm not uncomfortable with the idea of using these minerals or other things beyond their 'expiration' dates. Does Zinc stop being Zinc after a date on the bottle says so? I don't think so. Does Vitamin C become something else after a magical date on the bottle? I doubt it. I'm sure that expiration dates are valid for some medications -- the potencies may decline; perhaps some chemical reactions occurring in the materials may render them less effective (and, in some cases, possibly dangerous), but for the majority of supplements, I suspect that, for the manufacturers, expiration dates accomplish two purposes: it shields the manufacturer against any claims that a medication caused damage ('you took an expired medication') and also helps to sell more.

I'm sure that I'll be getting contrary opinion from some pharmacists or others about how wrong this thinking is -- but in many cases, I suspect that many 'expired' medications (with the exception, absolutely, for antibiotics that require refrigeration and other medications requiring special handling) are still good long after the expiration date.

(In my case, I was using some OTC medications that were near or past their expiration dates for financial reasons. I'm not sure how effective any of these were - either before or after expiration dates - but I don't think that there was much change from before to after the expiration date. Now that I'm able to buy these things a bit fresher, I often don't, partially out of habit and partially because it didn't seem to make any difference whether or not the OTC was expired).

Now - excuse me while I jump off my soapbox.

(I know that this probably should be in a new thread - I'm responding to your comments about how traditional medicine failed you -- as it does many others, including my DW)

I too, with my own health struggles beginning over 25 years ago, was walking along, blundering in the dark as you say. No internet then - was a pretty lonely road. Glad you and Dick are brave souls forging the way forward for those of us newbies coming along behind!

Sorry, I may have just started a whole row of soapbox litanies!! I won't even comment on what you said Protimenow; this may just fall under a new thread...but good for you for thinking with your head, rather than simply following orders blindly. Of course, caution is required...ooops, I'm climbing up on the soapbox with you!

I am sorry to hear that your DW has had her own struggles. I empathize as a medical person and a patient too!