Malarone and increased INR

[DiscoG4]

Hello all,

It's been a while since I've posted anything on this excellent forum, but though I'd just drop a note about my recent experience with the anti-malarial drug: Malarone. As a celebration for what has been a difficult year, we decided to take a holiday in Southern India, which is a malarial area. I consulted my GP prior to going on holiday and after checking he advised that the only anti-malarial drug a person taking warfarin would be safe on was Malarone, all other anti-malarial tablets appear to have a known interaction with Warfarin. Malarone has no documented interaction according to the manufacturers and my Doctor

I took my Coaguchek XS on holiday with me and about a week into the holiday decided to check my INR, my INR range is 2.5 to 3.0 and is usually fairly stable on 6 / 7 mg (even after a couple of pints of beer!). I was therefore a bit alarmed to find it at 4.4! I took a reduced dose of 5 mg and didn't have my customary couple of beers tested again a day later to find it was now 4.6. Only reducing the dose down to 3 mg bought my INR down to around 3.5 and taking a reduced dose of 3 to 4 mg for the rest of the week kept it within the target range.

So if you are considering taking this, you may want to be aware of a possible interaction, info can be found at:

http://www.hpa.org.uk/infections/topics_az/malaria/malaria_faq.htm

(This is UK site)

Proguanil seems to be the ingredient that may be causing an increased effect, according to the research I've done on the web. Would be very interested to hear if any other travellers have had a similar experience.

All the best

Steve

 

[catwoman]

Steve:

I wouldn't have been concerned about an INR increase, since Malarone was to be taken for only a short time -- not indefinitely.
For most people, INRs of 4.4 and 4.6 aren't going to cause a problem.

Now, if you were going to stay on Malarone, that might be a horse of another color.

 

[Ross]

Your INR was probably more diet related then drug related. At any rate, I wouldn't have worried about it unless it went above 5.0.

 

[Guest]

Travel broadens the and loosens the bowels.

My guess is that Malarone was a marker that you had made many sudden changes jn your life. The key to managing warfarin is routine. The reason for a holiday is to get away from routine for awhile. THerefore, it is almost a given that a trip of this magnitude will affect the INR whether you took Malarone or not.

It is much easier to lay the blame on a drug instead of laying it on having fun. Who wants to admit that fun is harmful?

An INR of 4.4 is hardly ever a cause for alarm.

 

[Karlynn]

Travel broadens the and loosens the bowels.

Geeze, I wish! It does the opposite to me.