My first experiance...

[Roger Frank]

...with intestinal flu while on Coumaden. I've come the conclusion it's like *riding the bubble*...fall off one side you can bleed to death while the other may stroke you out.

I went from 2.8 to almost 6 in three days. I only suspected something was wrong when I started to have blood in my urine. The Doc sent me to the ER who only suggested I see a urologist in the morning. Fortunately, things cleared up later that evening and I skipped the specialist trip.

I have a monitor and I'm now painfully aware to check daily when illness strikes.

My 2 cents,

 

[Ross]

...with intestinal flu while on Coumaden. I've come the conclusion it's like *riding the bubble*...fall off one side you can bleed to death while the other may stroke you out.

I went from 2.8 to almost 6 in three days. I only suspected something was wrong when I started to have blood in my urine. The Doc sent me to the ER who only suggested I see a urologist in the morning. Fortunately, things cleared up later that evening and I skipped the specialist trip.

I have a monitor and I'm now painfully aware to check daily when illness strikes.

My 2 cents,

I wouldn't freak out at 6, but I'd sure hold 2 doses. Question is, besides illness, did you take any antibiotics?

 

[Roger Frank]

I wouldn't freak out at 6, but I'd sure hold 2 doses. Question is, besides illness, did you take any antibiotics?

Ross they stuck me on Cefzil. Would that have a major effect?

 

[ALCapshaw2]

Ross they stuck me on Cefzil. Would that have a major effect?

The First Question to ask both your Doctor AND your Pharmacist is:
Will this new drug have any effect on my INR / Coumadin?

You can also Google the drug name which should bring up links to several Drug Information websites, maybe even givng links to "Side-effects" or some such reference.

'AL Capshaw'

 

[Roger Frank]

The First Question to ask both your Doctor AND your Pharmacist is:
Will this new drug have any effect on my INR / Coumadin?

You can also Google the drug name which should bring up links to several Drug Information websites, maybe even givng links to "Side-effects" or some such reference.

'AL Capshaw'

I didn't think to ask the prescribing ER Physician but I did later ask my substitute primary. (you might know my trusted primary's on vacation) Anyway...the sub felt there would be some interaction and has reduced my anticoagulant from 5 to 4 mg per day. Not being an expert this didn't sound like much of a correction...but perhaps it is.

Thanks for your help!
RF

 

[bvdr]

Roger, I know how frustrating it can get at times when one's INR fluctuates in response to other illnesses or medications. Just one thought to keep in mind though...even with a high INR blood would not be in the urine unless something was causing it. I think it is actually an advantage those of us on coumadin have over those who are not. We get an earlier warning by the presence of blood where it shouldn't normally be. I suggest you do keep that appointment with the specialist to see if there is something that needs attention.

 

[dick0236]

.... reduced my anticoagulant from 5 to 4 mg per day. Not being an expert this didn't sound like much of a correction...but perhaps it is.

Thanks for your help!
RF

5 to 4 mg/day is a 20% decrease. Thats a significant change but according to Al L's charting it may not be quite enough. Since you had some blood and INR of 6, Al's chart says to "hold warfarin and recheck in 24-48 hours until back in range. When back in range reduce 15-20% and recheck in 3-7 days". Al's algorithm is very helpful. It only costs a couple bucks and is available on his website, Warfarin.com(I think). I haven't had blood in my urine for 25 years. It doesn't happen very often, and then only when some significant event happens. I was in the south of Spain and was scared to death that I would end up in a Spanish hospital....and I don't speak spanish. I held a day or two dose, drank a lot of water, and everything seemingly returned to normal. By the time we got back to the USA, my INR (they called it pro-time back then) was back in range.

 

[Ross]

Yes, when they started you on the Cefzil, they should have had you test 3 days later because it will cause INR to rise rapidly. Not all antibiotics do this, only some.

Sulfa based and Cephalosporins do.

Cephalosporins
Moderate
Delayed
Poor
• Methylthiotetrazole ring in cefoperazone (Cefobid), cefamandole (Mandol), cefotetan (Cefotan) and cefmetazole (Zefazone) inhibits production of vitamin K*dependent clotting factors • Avoid concomitant use of warfarin and cefoperazone, cefamandole, cefotetan or cefmetazole.

http://www.aafp.org/afp/990201ap/635.html

 

[olefin]

Last year, one Saturday morning about 2 AM my urine looked like pure blood. Went to ER, first thing they checked was INR, it was normal. They put me on a antibiotic that didn't help. After the weekend saw my Urologists, he put me on a different antibiotic that immediately helped. I had a bladder infection.

Great info Al.
I've had better luck checking with the Pharmacist or online. My Cardiologist once prescribed a drug, he said it didn't effect INR. I got home and went online and found out it did! Also confirmed with Pharmacist.

 

[Roger Frank]

Yes, when they started you on the Cefzil, they should have had you test 3 days later because it will cause INR to rise rapidly. Not all antibiotics do this, only some.

Sulfa based and Cephalosporins do.

Cephalosporins
Moderate
Delayed
Poor
? Methylthiotetrazole ring in cefoperazone (Cefobid), cefamandole (Mandol), cefotetan (Cefotan) and cefmetazole (Zefazone) inhibits production of vitamin K*dependent clotting factors ? Avoid concomitant use of warfarin and cefoperazone, cefamandole, cefotetan or cefmetazole.

http://www.aafp.org/afp/990201ap/635.html

Thanks for the information Ross. Will it fall like a rock when I finish my coarse of medication?

 

[Roger Frank]

Last year, one Saturday morning about 2 AM my urine looked like pure blood. Went to ER, first thing they checked was INR, it was normal. They put me on a antibiotic that didn't help. After the weekend saw my Urologists, he put me on a different antibiotic that immediately helped. I had a bladder infection.

Great info Al.
I've had better luck checking with the Pharmacist or online. My Cardiologist once prescribed a drug, he said it didn't effect INR. I got home and went online and found out it did! Also confirmed with Pharmacist.

It's an attention getter!

Thanks for sharing your experience...I feel like I have friends in the fight.

RF

 

[neil]

hi seems like your having a rough time,hope things get better for you soon, chin up............

 

[Ross]

Thanks for the information Ross. Will it fall like a rock when I finish my coarse of medication?

It should, so be prepared to go back to your usual dose. I'm not sure how long it takes for the antibiotic to wash out, but I'm thinking about a week, so you may want to check your INR 3 days after stopping it and see where your at.