Pain Meds when on Coumadin

[The Bionic Duo]

Bob has been having shoulder problems on and off for about a year now, and he finally had an MRI last week and saw the DR today--seems he has a torn rotator cuff and will probably have to have surgery. He asked the DR if there was anything stronger than Tyenol he could take for the pain, and the DR told him nothing that wouldn't interfere with the coumadin. Is this a fact, I know they gave him darvocet after the OHS, but I don't know if that is suitable for the shoulder pain?

Thanks
Joan

 

[tommy]

Try again. Surely you have the option of taking pain medicine and adjusting the Coumadin dose. It may mean more frequent testing for a while, but I would take more skin pricks or blood draws than put up with chronic pain.

 

[Sherry]

Hi, Joan. I have taken flexeril (low dose) for a few months for a similar shoulder/back problem. I haven't seen any fluctuations in my INR. You may want to ask his doc about that.

 

[Yaps]

I take

I take

1/2 darvocet daily.... no one has said not to, in fact with the pain from PAD, they reccomend it, better than pain causing a worse problem(another heart attack???)

 

[Guest]

Tom had the best idea - take what you need and adjust the warfarin dose. I hear this so often from doctors, "I want to use XXX on YYY but I can't because it interacts with warfarin. What is the next best choice." My reply, "use what you want and refer them to me so that I can adjust the warfarin around what you want to use."

The Darvocet is also a possibility. A lot of people don't like Darvocet but it seems safe with warfarin.

 

[The Bionic Duo]

Thanks all

Thanks all

Tom and Al

You've confirmed what I thought was the case, I'll pass it on to Bob and maybe he can see what can be done. I had already sugested to him to see his PCP about the pain, thinking she may have a little more savy reguarding coumadin therapy and pain management--I found out she see's a lot of people for pain management when they gave me this strange form to fill out the last time I went to see her. (In true mismanaged form they had misplaced part of my records and just assumed I was one of their pain management patients.)

I personally don't trust the Ostio to do very well with comoudin management--my OS DR who is part of the same group never seem to understand what coagualtion range I should be in when he put me on coumadin after my knee surgery.

Joan

 

[Bionic Man]

I had Lortab after OHS

I had Lortab after OHS

I just think they have to watch your INR as you start and get on the med. Lortabs were GREAT for muscle pain/swelling.

 

[Barry]

I take Vicodin prn for pain, doesn't appear to affect my INR. I think, but don't know, that opiates in general don't have a problem with interacting with Warfarin. Problem is that opiates are addicting, and a lot of folks abuse them - especially Vicodin - so if you've got to be judicious in how you take them and you've got to find a doc who doesn't mind the DEA constantly looking over his/her shoulder because they're prescribing opiates.

 

[Guest]

Here is how the DEA works. They have the right to inspect prescriptions in a pharmacy. If the pharmacist refuses, they can get a subpoena. They routinely look at maybe 300 to 500 consecutive prescriptions. If they see 2 or 3 for controlled substances from a doctor in the area - no big deal. If they see 6 or 8 (or some number) from the same doc for the same controlled drug, they go looking at all the pharmacies around. If the find the same pattern they get suspicious and widen the search area.

The other thing that tips them off is if they see several prescriptions for controlled substances from some doctor whose office is miles away. Particularly they are suspicious if the doctor is in something like family practice when there might be 20 or 30 similar doctors closer to the pharmacy.

One inspector that I knew said that the difference between random findings and fraud was so big that he was confident that he never had prosecuted a case that was a mistake.

 

[Guest]

Not to mention the risk of a bleeding ulcer with 10-12 Advil daily. It gives no warning because it does not affect the INR.

 

[Lisa in Katy]

I've taken Vicodin after surgeries with no problems. Also, I was recently told that since Vioxx is no longer available, which is what I used to take for random headaches, chronic pericarditis, etc., I can take Alleve. This is OTC. Can this be true?

 

[The Bionic Duo]

Thanks everyone

Thanks everyone

I told Bob about your reply's, he thinks he'll pass on pain meds for the time being. He suspects his OS purposely didn't give him pain meds so he won't be tempted to overdo excercising. The Doc is right--Bob does have a tendancy to overdo things--thinks if he can do 10 pushup 30 would be better sort of thing.

Interesting discussions going on here about pain meds and sleeping pills. My OS has never been stingy with the pain meds--which is good right now since the knee I didn't have replaced has now gone south I really need them. My PCP also just renewed my sleeping pill prescription when I told her that taking diuretics are hard on a nights sleep Makes me kind of wonder how any Orthopedic surgeon could possibly pass those pharmacy inspection for addictive pain prescrptions.

Anyway thanks, if Bob gets real uncomfortable I can always sneak him one of my hydrocodin's (I know, you shouldn't take someone else's prescriptions).

Joan

 

[Barry]

...Bob does have a tendancy to overdo things--thinks if he can do 10 pushup 30 would be better sort of thing...

Tsk, tsk.

Some time ago I heard on the radio one of your standard interviews with some old geezer who'd reached 100 and was asked for the secret of his longevity. Bob could benefit perhaps from a bit of this wisdom - although with his tendency to overdo things he'd probably take it literally:

"Well, I never run when I can walk. I never walk when I can stand. I never stand when I can sit. I never sit when I can lie down. And I'm never awake when I can be asleep."

Ah, now that's my idea of a physical fitness regimen!

 

[The Bionic Duo]

Tsk, tsk.

"Well, I never run when I can walk. I never walk when I can stand. I never stand when I can sit. I never sit when I can lie down. And I'm never awake when I can be asleep."

Ah, now that's my idea of a physical fitness regimen!

Hee hee

Mine too--I'm always trying to get him to (Bob might call it nagging) do things in moderation--but its an uphill battle with Bob.

 

[Guest]

Lisa,
Vioxx was taken off the market in September. There were a statistically significant number of people who died from heart problems at high doses.

 

[alicia]

Al, remember me? IM the one who developed a 10cm bloodclot while taking Vioxx after an oopherectomy? My clot is finaly gone after 1 year of misery. I've taken Lortab when the pain was unbearable and it didnt seem to affect my INR/PT. In 1997 I took Redux for just 2 months and its suspected that caused ALL of my heart problems. Now it seems Vioxx may have caused the clot after taking it for only 4 months. What is it with me and meds?


Alicia

 

[Guest]

I know that some attorneys have solicited clients who had blood clots in veins when taking Vioxx, but I think that the studies only showed arterial clots. The mechanisms of clot formation appear to be quite different in arteries and veins. Yours sounds like a clot in a vein.

 

[Lisa in Katy]

Aleve

Aleve

My post was misinterpreted, probably because I wrote it poorly. I know that Vioxx was taken off the market. I was wondering if Aleve is really okay to take with Coumadin. Thanks.

 

[catwoman]

Lisa:

Alleve is ibuprofen, which can cause gastrointestinal bleeding. Not good for folks on Coumadin.

 

[Guest]

Alleve is naproxen which I can't find any report of it causing bleeding.

Motrin, Nuprin and Advil are ibuprofen. These have a high risk of causing bleeding.