Perhaps this is a Stupid Question?

[Petros]

Can these ups and downs in INR produce any bad effects in a human's organism? Is it possible that these can damage any internal organ in our body both in the short or long-run?
Generally speaking, what are the bad effects of taking such a chemical other than the "bleeding" risk?

 

[JimL]

I'll guess at an answer. I mean, it does make sense that if the medicine was used to kill rats, it might have a harmful effect on a human. And therefore, taking excessive amounts of warfarin would accentuate the risk.
However, the dosage of warfarin we take to maintain an INR around 3.0 is far, far lower than the dosage that used to be given to rats to maintain their INR, so to speak, at 3000.0 or so.
I think that's the answer: We take such a low dosage that the harmful effects are all but not present, and only the good effects of slowing the coagulation rate are present.

 

[R&N Brown]

That's a good question.
I know folks here have taken the drug for many years without issue. My father did for a stretch too, no issues. Although I have often wondered what the long-term effect could be on say your liver or kidneys.

Rob

 

[tobagotwo]

There was a study a couple of years ago that suggested that long-term use can cause calcium issues, as vitamin K is a part of that cycle, but I don't think I've seen any followup or more substantial outcomes listed.

As is pointed out above, an awful lot of people have been on Coumadin for an awful lot of time.

There are many interactions between warfarin and other drugs, so it does need to be kept in mind. However, most of the interactions have to do with their affect on your INR, rather than internal organ damage.

Best wishes,

 

[netmiff]

how warfarin killed rats (and other rodents, too) is to "thin" the blood so much that they spontaneously bleed to death internally. They had to have massive (comparably, weight for weight) to do this. So, the small doses that we are subject to, and the monitoring that we get, should prevent this rather nasty "side effect". As to the long-term effects on other major organs, my own personal attitude is that I will deal with it if it happens - I have just been given 2 years of life so far that I wouldn't have had if I hadn't had the valve replaced.

I know where you are coming from with your question, I am on other meds long-term, and when I asked that doc about the long-term effects, he was aghast and questioned iif I was thinking of stopping them. I explained that I wasn't, but that I went for annual physicals, and my PCP and I would just throw in a few extra kidney function tests if kidney problems were a known side effect, and that we would both know what to watch out for in the future.

 

[catwoman]

Warfarin has been used as an anticoagulant in humans since the early 1950s -- going on 60 years. That is certainly long enough for medical science to determine whether frequent blood tests are required to show if warfarin -- taken to maintain the INR in a suggested range per the medical need -- is negatively affecting major organs, liver, heart, kidneys, etc.
We have a number of people here at vr.com who have been on warfarin for years and can attest to this.

There are other Rxes that do affect major organs, thus requiring periodic tests for liver values, etc.

 

[ALCapshaw2]

This Question / Discussion begs the Question:

At what level would Coumadin / Warfarin result in fatal Bleeding in a human?

I know this Dose will vary widely between fast metabolizers and slow metabolizers, but could an effective INR be established (perhaps over a Wide Range)?

How many 'Daily Doses' would it take to cause 'trouble'?

I *assume* it would also depend on how fast that human could receive medical attention / treatment (Vitamin K, Fresh Frozen Plasma, etc.)

 

[geebee]

I have been on coumadin for almost 29 years. I have a few medical issues but nothing that has been attributed to long term ACT.

I do have some slight bone density loss but that could just as easily be connected to getting older. I had a bone denisity test in 2000 and one a few weeks ago and nothing has changed so, if it is connected to coumadin, it is not progressing. However, I did start calcium supplements after the first one so that probably helped.

Calcium loss would be the only thing I wonder about and it is controllable no matter what the reason.

 

[catwoman]

Like Gina said, calcium loss can be from a lot of different things -- not just warfarin -- steroids, anorexia, alcoholism, tobacco and I've been told caffeine. Warfarin is not listed among the Rxes in an article about osteoporosis at the Cleveland Clinic's website.

And you can take a variety of Rxes and OTCs to combat calcium loss and osteopenia/osteoporosis.

BTW: If your doctor ever Rxes something, please do take it. My dad pooh-poohed it, and is now having to give himself shots daily to combat his osteoporosis. He's always been a thin person, but he's very thin at 80, and my sisters & I pray he does not take a tumble.

 

[netmiff]

I was diagnosed with bad osteoporosis at ae 50; I drink milk, love yogourt and you can't keep me away from the cheese tray at a party! I only had my AVR (and therefore started warfarin) at 52, so the ACT was not the cause of my ostoporosis.

 

[Matski]

i've been on coumadin now for 30 years, 3 months and have had no negative reaction to my long term use of coumadin other than a few internal bleeding issues when my inr got really screwed up as a kid.

 

[dick0236]

I have been on coumadin/warfarin for 42+ years without any unusual issues, other than problems caused by my ignorance and inattention. I am 73+ years old and have no issues with bones (I have never had a broken bone). I have never had a doctor caution me about "long term issues" involving ACT. Over the years, my dosage has come down from 70mg/wk as a young man to 35mg/wk now...most probably due to a reduction in activity and change in lifestyle.

 

[Herb M]

I have been on Coumadin for 20 years. The only problem I have is listening to my wife who says I should stop taking that rat poison.

 

[olefin]

I've been on warfarin for over 18 years. I'm very disappointed with it! It hasn't help my looks a bit! And the stuff hasn't kept me from getting older!

 

[terodac]

I also wonder if your body gets use to it and then you can take less of it. I take 10mg a day but lately have had to cut it back to 7.5 or 5.0 for a couple of days to maintain my 3.3. I have not changed anything other than I am watching what I eat and taking vitamin C 500 mg a day.

 

[Petros]

I also wonder if your body gets use to it and then you can take less of it. I take 10mg a day but lately have had to cut it back to 7.5 or 5.0 for a couple of days to maintain my 3.3. I have not changed anything other than I am watching what I eat and taking vitamin C 500 mg a day.

I am also experiencing the same situation. My usual dose was 11 & 12,5mg (day by day) and my INR was very sensitive when reducing or increasing warfarin. I am now taking 10 or 11mg trying (after two years of taking warfarin) to "re-discover" what would be again the right dose in order to maintain my INR at around 3.0.

 

[catwoman]

I also wonder if your body gets use to it and then you can take less of it. I take 10mg a day but lately have had to cut it back to 7.5 or 5.0 for a couple of days to maintain my 3.3. I have not changed anything other than I am watching what I eat and taking vitamin C 500 mg a day.

Your body does not "get used to" warfarin. A variety of factors affect how well your body metabolizes it: other meds and OTCs, including herbals; overall health; activity level; diet; etc. etc.

You're trying to maintain your INR at 3.3. That's extremely rigid. You mention watching what you eat -- are you trying to lose weight or just overseeing what you eat to avoid eating too much vitamin K?

Your profile doesn't mention a DOB or your age. It does mention your 89YO father. So I'm assuming you're probably in your late 50s (or older)? As we age, our bodies become more sensitive to ALL drugs -- our body is less able to metabolize drugs -- and dosages must be changed accordingly. That said, I was surprised that my husband needed 7.5mg of warfarin to get to 2.0 when he was on warfarin for 7 months post MV repair. He was 61 at the time. I was taking 5 and 5.5mg to stay 2.5-3.5 and I was 57 at the time. Go figure.

 

[catwoman]

I am also experiencing the same situation. My usual dose was 11 & 12,5mg (day by day) and my INR was very sensitive when reducing or increasing warfarin. I am now taking 10 or 11mg trying (after two years of taking warfarin) to "re-discover" what would be again the right dose in order to maintain my INR at around 3.0.

Petros:

I've gone through periods like this in the last 6 years. I went through it earlier this year. I'm now back on an even keel at 3X6mg and 4X5.5mg.