How many members take aspirin and Warfarin?

[Natanni]

Tried to do this under a poll;

How many members take Enteric Coated Aspirin (81mg or 325) in addition to Warfarin? My husband was given Aspirin immediately after surgery and was told that it is recommded for the first year post AVR. At his one year check up,his cardio told him to continue since he was having no issues with it. I do remember reading that there was promising results for combining ASA with Warfarin. My question is for a man in his mid thirties with normal sinus rhythm, normal EF, AVR- is it really necessary to give him/her a second form of anticoagulation with it's own bleeding problems (and less able to regulate) ? I know people who are now on Warfarin because they had bleeding problems from Enteric Coated Aspirin, so it is not all unoffending. I wonder if it is worth it to risk an aspirin bleed (for someone who is going to have to take Warfarin for 40 years) to get the extra benefit of reducing a stroke now?

 

[geebee]

I think it has been pretty much proven that taking up to one, 325mg aspirin per day is not dangerous when combined with coumadin and is very beneficial. I started the aspirin due to TIAs and I rarely have them anymore.

 

[Ross]

Ever since surgery, 81mg aspirin once a day along with thy Coumadin. According to the pro's, yes, there is a definate benefit to doing both.

 

[Susan BAV]

From American Heart Association website

From American Heart Association website

Very recently, I was told here by Ross that aspirin is not a recognized anticoagulant. Personally, I don't know. But I just now quickly searched aspirin and found this, cut and pasted as follows from the American Heart Association website, and I hope you find it helpful:

Anticoagulation

Some people with congenital heart defects, especially those who are cyanotic (blue), have had heart valve replacements or have had complicated surgeries such as the Fontan operation, may need to take anticoagulants (blood-thinners). These medicines slow blood clotting. They're used to prevent major complications, such as vessel or valve obstruction, or strokes. Anticoagulants may be given by mouth. In some cases they're given intravenously or by injecting them just under the skin. Bleeding may be a complication of taking these medications, so tell your cardiologist if you begin to have easy bruising, bleeding gums or nosebleeds.

Oral Medications

These mainly include aspirin (and other antiplatelet medications) and warfarin (Coumadin). Each of these medicines works on a different part of the blood-clotting cycle. Your cardiologist will decide which of these medications is right for you.

Aspirin tends to cause fewer bleeding complications. However, it may upset your stomach and be ineffective for treating your specific heart problem.

Warfarin increases your risk of serious bleeding problems. If you take warfarin, you may need to limit your activity to reduce the chance of injury, particularly a head injury. Warfarin also can cause malformations in an unborn child, so don't take it during pregnancy. Some form of anticoagulant medication as prescribed by your cardiologist and obstetrician is recommended throughout pregnancy, however. (See the section below on Subcutaneous Medications.)

Intravenous Medications

Heparin is the main intravenous blood thinner. It's used mostly in hospitals after heart operations while the dosage of the oral medication, warfarin or aspirin, is being adjusted. Oral anticoagulants are longer-acting, so if you need elective surgery (including dental surgery), these medications may need to be stopped and intravenous or subcutaneous, shorter-acting heparin begun in the hospital before surgery. Your doctor will decide if this is necessary.

Subcutaneous Medications

Heparin also can be given by an injection just underneath the skin. This is sometimes done if it's required for a longer time (e.g., during pregnancy). This usually eliminates a long-term need for an intravenous line. Both heparin and low-molecular-weight heparin are available for subcutaneous injection. Your cardiologist will determine which is best for you.

Medication Monitoring

If you're taking warfarin, to be sure your dosage is correct, your doctor will regularly monitor blood-clotting indicators. A value called the INR (international normalized ratio) tests how quickly your blood clots. Your warfarin dosage will be carefully adjusted to maintain an INR level appropriate for your heart condition. You must take your medicine exactly as prescribed. You also must have your blood tested regularly according to your doctor's orders. People on long-term warfarin therapy could ask their doctor about the possibility of self-testing their INR by using a home INR monitor.

Medication and Diet Interactions With Warfarin

Many over-the-counter or prescription medicines can interact with warfarin and change your INR, which can be hazardous. These include erythromycin, cimetidine and several pain medicines (e.g., ibuprofen and other non-steroidal anti-inflammatory drugs). There are others, too. You also shouldn't take aspirin when you're being treated with warfarin.

Certain foods also interfere with how your body processes warfarin. Your cardiologist will discuss foods to avoid or eat regularly while taking coumadin. If you're on warfarin, always ask your doctor about your diet and before taking any other medicines, including vitamins and herbal preparations."

 

[Dennis S]

Hmm

Hmm

I don't see the point of this (Susan's) post. There is no controversy about taking aspirin with warfarin.

 

[geebee]

Very recently, I was told here by Ross that aspirin is not a recognized anticoagulant. Personally, I don't know. But I just now quickly searched aspirin and found this, cut and pasted as follows from the American Heart Association website, and I hope you find it helpful:

Anticoagulation

Some people with congenital heart defects, especially those who are cyanotic (blue), have had heart valve replacements or have had complicated surgeries such as the Fontan operation, may need to take anticoagulants (blood-thinners). These medicines slow blood clotting. They're used to prevent major complications, such as vessel or valve obstruction, or strokes. Anticoagulants may be given by mouth. In some cases they're given intravenously or by injecting them just under the skin. Bleeding may be a complication of taking these medications, so tell your cardiologist if you begin to have easy bruising, bleeding gums or nosebleeds.

Oral Medications

These mainly include aspirin (and other antiplatelet medications) and warfarin (Coumadin). Each of these medicines works on a different part of the blood-clotting cycle. Your cardiologist will decide which of these medications is right for you.

Aspirin tends to cause fewer bleeding complications. However, it may upset your stomach and be ineffective for treating your specific heart problem.

Warfarin increases your risk of serious bleeding problems. If you take warfarin, you may need to limit your activity to reduce the chance of injury, particularly a head injury. Warfarin also can cause malformations in an unborn child, so don't take it during pregnancy. Some form of anticoagulant medication as prescribed by your cardiologist and obstetrician is recommended throughout pregnancy, however. (See the section below on Subcutaneous Medications.)

Intravenous Medications

Heparin is the main intravenous blood thinner. It's used mostly in hospitals after heart operations while the dosage of the oral medication, warfarin or aspirin, is being adjusted. Oral anticoagulants are longer-acting, so if you need elective surgery (including dental surgery), these medications may need to be stopped and intravenous or subcutaneous, shorter-acting heparin begun in the hospital before surgery. Your doctor will decide if this is necessary.

Subcutaneous Medications

Heparin also can be given by an injection just underneath the skin. This is sometimes done if it's required for a longer time (e.g., during pregnancy). This usually eliminates a long-term need for an intravenous line. Both heparin and low-molecular-weight heparin are available for subcutaneous injection. Your cardiologist will determine which is best for you.

Medication Monitoring

If you're taking warfarin, to be sure your dosage is correct, your doctor will regularly monitor blood-clotting indicators. A value called the INR (international normalized ratio) tests how quickly your blood clots. Your warfarin dosage will be carefully adjusted to maintain an INR level appropriate for your heart condition. You must take your medicine exactly as prescribed. You also must have your blood tested regularly according to your doctor's orders. People on long-term warfarin therapy could ask their doctor about the possibility of self-testing their INR by using a home INR monitor.

Medication and Diet Interactions With Warfarin

Many over-the-counter or prescription medicines can interact with warfarin and change your INR, which can be hazardous. These include erythromycin, cimetidine and several pain medicines (e.g., ibuprofen and other non-steroidal anti-inflammatory drugs). There are others, too. You also shouldn't take aspirin when you're being treated with warfarin.

Certain foods also interfere with how your body processes warfarin. Your cardiologist will discuss foods to avoid or eat regularly while taking coumadin. If you're on warfarin, always ask your doctor about your diet and before taking any other medicines, including vitamins and herbal preparations."

I do not know if the "taking aspirin while on coumadin" line was in bold on the AHA website but I pay attention to my doctor's instructions. My implication of the line would be that one shouldn't just take aspirin on their own which, of course, is not what this thread was about. In addition, the fact that this article still uses the term "blood thinners" makes it anitquated in my book no matter when it was written.

 

[Natanni]

Very recently, I was told here by Ross that aspirin is not a recognized anticoagulant. Personally, I don't know. But I just now quickly searched aspirin and found this, cut and pasted as follows from the American Heart Association website, and I hope you find it helpful:

Anticoagulation

Some people with congenital heart defects, especially those who are cyanotic (blue), have had heart valve replacements or have had complicated surgeries such as the Fontan operation, may need to take anticoagulants (blood-thinners). These medicines slow blood clotting. They're used to prevent major complications, such as vessel or valve obstruction, or strokes. Anticoagulants may be given by mouth. In some cases they're given intravenously or by injecting them just under the skin. Bleeding may be a complication of taking these medications, so tell your cardiologist if you begin to have easy bruising, bleeding gums or nosebleeds.

Oral Medications

These mainly include aspirin (and other antiplatelet medications) and warfarin (Coumadin). Each of these medicines works on a different part of the blood-clotting cycle. Your cardiologist will decide which of these medications is right for you.

Aspirin tends to cause fewer bleeding complications. However, it may upset your stomach and be ineffective for treating your specific heart problem.

Warfarin increases your risk of serious bleeding problems. If you take warfarin, you may need to limit your activity to reduce the chance of injury, particularly a head injury. Warfarin also can cause malformations in an unborn child, so don't take it during pregnancy. Some form of anticoagulant medication as prescribed by your cardiologist and obstetrician is recommended throughout pregnancy, however. (See the section below on Subcutaneous Medications.)

Intravenous Medications

Heparin is the main intravenous blood thinner. It's used mostly in hospitals after heart operations while the dosage of the oral medication, warfarin or aspirin, is being adjusted. Oral anticoagulants are longer-acting, so if you need elective surgery (including dental surgery), these medications may need to be stopped and intravenous or subcutaneous, shorter-acting heparin begun in the hospital before surgery. Your doctor will decide if this is necessary.

Subcutaneous Medications

Heparin also can be given by an injection just underneath the skin. This is sometimes done if it's required for a longer time (e.g., during pregnancy). This usually eliminates a long-term need for an intravenous line. Both heparin and low-molecular-weight heparin are available for subcutaneous injection. Your cardiologist will determine which is best for you.

Medication Monitoring

If you're taking warfarin, to be sure your dosage is correct, your doctor will regularly monitor blood-clotting indicators. A value called the INR (international normalized ratio) tests how quickly your blood clots. Your warfarin dosage will be carefully adjusted to maintain an INR level appropriate for your heart condition. You must take your medicine exactly as prescribed. You also must have your blood tested regularly according to your doctor's orders. People on long-term warfarin therapy could ask their doctor about the possibility of self-testing their INR by using a home INR monitor.

Medication and Diet Interactions With Warfarin

Many over-the-counter or prescription medicines can interact with warfarin and change your INR, which can be hazardous. These include erythromycin, cimetidine and several pain medicines (e.g., ibuprofen and other non-steroidal anti-inflammatory drugs). There are others, too. You also shouldn't take aspirin when you're being treated with warfarin.

Certain foods also interfere with how your body processes warfarin. Your cardiologist will discuss foods to avoid or eat regularly while taking coumadin. If you're on warfarin, always ask your doctor about your diet and before taking any other medicines, including vitamins and herbal preparations."

Yes, I goofed about aspirin being an anticoagulant. Our bottle of EC aspirin 81 mg states "Talk to your doctor before taking this product if you are on Coumadin", but not contraindicated. My husband also got the go ahead for Ibuprofen for migranes. I know that Asprin and Warfarin can be taken together. My question is, isn't properly managed warfarin enough for an aortic mechanical valve (without EF issues, A Fib, etc ) vs adding an extra risk of ulcers from aspirin?

 

[Susan BAV]

I don't see the point of this (Susan's) post. There is no controversy about taking aspirin with warfarin.

I do not know if the "taking aspirin while on coumadin" line was in bold on the AHA website but I pay attention to my doctor's instructions. My implication of the line would be that one shouldn't just take aspirin on their own which, of course, is not what this thread was about. In addition, the fact that this article still uses the term "blood thinners" makes it anitquated in my book no matter when it was written.

I posted the current information from AHA and bolded it because I thought it was relevant to the thread question in a helpful manner; and it is the current recommendation from the American Heart Association. Maybe you didn't see that I wrote, "I hope you find this helpful." Perhaps I'm not understanding the intention of your posts.

(Edit and apology for Natanni - I received a correction by PM about aspirin; it IS some form of anticoagulant.)

 

[geebee]

The intention of my post was to, once again, point out the fallacies that are still so prevalent about coumadin. It doesn't matter to me if the information came from the AHA - some of it is just plain incorrect.

 

[Granbonny]

I don't take any aspirin..just warfarin..Cardio has never mentioned taking it..in over 5 years....glad, because Hubby takes 1 every day..his arms stay bruised.. but, he still does heavy outside type work.....I don't.. Even with the fall last week in driveway..NO bruises.. I would like to know if you members taking aspirin along with coumadin bruise more? Reason..I ran out of my Tylenol..for old ache pains and hate to get back on roads this long weekend..may take an aspirin tonight?..don't think a couple will make me bruise . ......Bonnie

 

[geebee]

I don't take any aspirin..just warfarin..Cardio has never mentioned taking it..in over 5 years....glad, because Hubby takes 1 every day..his arms stay bruised.. but, he still does heavy outside type work.....I don't.. Even with the fall last week in driveway..NO bruises.. I would like to know if you members taking aspirin along with coumadin bruise more? Reason..I ran out of my Tylenol..for old ache pains and hate to get back on roads this long weekend..may take an aspirin tonight?..don't think a couple will make me bruise . ......Bonnie

Bonnie,

I do not notice any more bruising with the addition of aspirin to my coumadin. I do bruise pretty easily but the amount is the same as before the aspirin. However, I do only take 1/2 aspirin a day.

 

[geebee]

Yes, I goofed about aspirin being an anticoagulant. Our bottle of EC aspirin 81 mg states "Talk to your doctor before taking this product if you are on Coumadin", but not contraindicated. My husband also got the go ahead for Ibuprofen for migranes. I know that Asprin and Warfarin can be taken together. My question is, isn't properly managed warfarin enough for an aortic mechanical valve (without EF issues, A Fib, etc ) vs adding an extra risk of ulcers from aspirin?

Actually aspirin is a type of anticoagulant. In any case, if Nathan does not have any issues with TIAs, he may not need aspirin. I think it really depends on each person's history. I did not take aspirin for the first 13 years I had my mechanical valve and was just fine. Perhaps a conversation with his doctor about the reasons for the aspirin might make you more comfortable.

 

[Granbonny]

Thanks Geebie

Thanks Geebie

And Natanni for starting this thread. I will take 1 of hubby's 81mg tonight... Been running around the last 3 days..Grandson's out of town kindergarden graduation and today volunteering all day at local Fireman's huge Bar-be-Que.......funny, how I have never mentioned this to Cardio> taking an aspirin for pain?...Will remember to ask him the next visit..Bonnie

 

[Bina]

My instructions from the chief of cardiac and thoracic surgery:

Take daily: Coumadin
Aspirin 81mg LOW DOSE (enteric coated-dissolves in intestine)

The aspirin makes the blood more "slippery", it does not affect bruising.

It is recommended to take Tylenol for other pain relief.

 

[Dennis S]

You hit the nail on the head.

You hit the nail on the head.

Good post, Bina. I would venture to guess that 80 to 90% of cardiologists (at least for mech valve implants in the last couple of years) have recommended a combination of aspirin and warfarin. I assume the poll will continue to demostrate that.

Bina is also correct that aspirin does not cause bruising. Aspirin and warfarin help in 2 different ways to prevent clotting-there just is no controversy here.

 

[OldNick]

Coumadin and 81mg Enteric Coated Aspirin

Coumadin and 81mg Enteric Coated Aspirin

I have been on Coumadin for over 13 years, and have also taken 81mg aspirin for much of that time on the advice of my Cardiologist. I have occasional vision events that could be TIA-related. I bruise easily, but I blame that on the Coumadin.

 

[Bridgette]

I take 7mg Warfarin daily, and one 100mg Aspirin daily. In NZ you can get enteric coated aspirin in 75mg, 100mg, 150mg doses. Or you can take the non-enteric coated aspirin in 300mg or extra strength 500mg, but taking them for prolonged periods is pretty hard on the stomach.


I understood that aspirin prevented platelet aggregation while warfarin slows clotting time of the blood, so they work in different ways on the blood?

Bridgette

 

[cirrider]

Currently my surgeon (who is also a friend) wants me to begin taking 81 mg of aspirin. My cardio has not been very reponsive one way or another. So, here is my question. For those who started aspirin after they started Warfarin, did you notice any change in you INR? Did you have to adjust the Warfarin due to the aspirin? I talked with a fairly prominent Hemotoligist and was told that if you hometest, you can basically do what you want with supplements etc, as long as you do your testing and adjust accordingly. I have been taking Wafarin now for about 1 1/2 yrs. and have remained fairly stable, even though I have added 1000 mg of fish oil and a garlic supplement. So after reading the posts in this thread, I will probably begin to take the aspirin, but would like to know what to expect. Thanks

 

[geebee]

Aspirin does not show up in the INR.

 

[RCB]

So far, so good

So far, so good

On Aspirin since 1977, when my my cardiologists "suspected" it might lower the risk of a clot and have only stopped it prior to major surgery. No problems
with it so far.