Things in Nature that Affect the INR

[pedpatientmom]

I am interested to learn from you all if you have experienced any scares due to ingesting anything out in nature. Are Warfarin patients affected by ocean water, sand, pollen, grass, dirt, flowers? I have a 4 year old and a 2 year old who love to play outside and I am a big advocate of handwashing after we come in from outside. But I do not know what to expect if the children should get really curious and put something in their mouths. I am interested to learn from your experiences. Thank you.

 

[MdaPA]

I am interested to learn from you all if you have experienced any scares due to ingesting anything out in nature. Are Warfarin patients affected by ocean water, sand, pollen, grass, dirt, flowers? I have a 4 year old and a 2 year old who love to play outside and I am a big advocate of handwashing after we come in from outside. But I do not know what to expect if the children should get really curious and put something in their mouths.

Both kids are on Warfarin?

If they got sick (e.g. vomited) from ingesting ocean water, sand or dirt close to when they took Warfarin then I guess that could impact their INR.

Allergy medicine, If taking for the pollen, might have an interaction with Warfarin (check with your Dr./pharmacy).

Greens can be high in Vitamin K which counter-act the affects of Warfarin so there may be certain wild grass/weeds or flowers that could cause a problem in large amounts (e.g. herbs, clover, dandelion greens).

I can't imagine though that they would enjoy the taste of these things to cause them to ingest enough to have any impact.

 

[pellicle]

Are Warfarin patients affected by ocean water, sand, pollen, grass, dirt, flowers?

no no no and no ... you have been listening to fools

The things which effect INR are

1. grapefruit juice ... do not drink more than 100ml daily it will raise your INR
2. some drugs such as tylenol / paracetamol

that's also in order of significance. There are some other rare ones, but they're the biggest issue ones that you're likely to encounter in daily life (that I can think of right now).

Best Wishes

 

[pedpatientmom]

Thank you, MdaPA.

 

[pedpatientmom]

Thank you, pellicle.

 

[pellicle]

Thank you, pellicle.

no worries

just make sure you consult with a Dr before commencing any medication. Small bodies require less drug to influence their INR

out of interest what is their dose?

 

[MdaPA]

pedpatientmom,
You have in your profile, "Closed holes in heart and mitral valve implant". Do both your 4 year old and 2 year old have artificial heart valves that require Warfarin? If so, may I ask what kind and if they can be expanded/grow?

 

[tom in MO]

no no no and no ... you have been listening to fools

The things which effect INR are

1. grapefruit juice ... do not drink more than 100ml daily it will raise your INR
2. some drugs such as tylenol / paracetamol

that's also in order of significance. There are some other rare ones, but they're the biggest issue ones that you're likely to encounter in daily life (that I can think of right now).

Best Wishes

Tylenol aka acetaminophen does not effect my INR and is allowed by my cardiologist and internist with no restriction. It is an important drug for people of all ages.

 

[Superman]

no no no and no ... you have been listening to fools

The things which effect INR are

1. grapefruit juice ... do not drink more than 100ml daily it will raise your INR
2. some drugs such as tylenol / paracetamol

that's also in order of significance. There are some other rare ones, but they're the biggest issue ones that you're likely to encounter in daily life (that I can think of right now).

Best Wishes

I second that Tylenol has never been an issue. About the only thing I’ll take without running it by my pharmacist/wife first.

 

[Superman]

I am interested to learn from you all if you have experienced any scares due to ingesting anything out in nature. Are Warfarin patients affected by ocean water, sand, pollen, grass, dirt, flowers? I have a 4 year old and a 2 year old who love to play outside and I am a big advocate of handwashing after we come in from outside. But I do not know what to expect if the children should get really curious and put something in their mouths. I am interested to learn from your experiences. Thank you.

Never really thought about an allergic reaction affecting INR. I’ll ask my wife if epinephrine could. To me, that would be the more likely issue.

Dirt, sand, salt water - no, no, and no. Real kid risks would be more along the lines of scrapes, bumps, and bruises growing up. With my five kids, their love of horsing around, playgrounds, and things with wheels - we’ve had our share of broken arms, goose eggs (don’t turn around if you let them practice with golf clubs in the yard). But they aren’t on warfarin. I broke my thumb and had a small fracture on my elbow. Took weeks before it became problematic to finally go in. I was quite surprised to learn I needed a cast. But no warfarin / internal bleeding issues with those. I’ve had poison ivy while on warfarin as well without issue. Dropped a sizable armoire on my foot (that turned purple).

Really, not too many things spanning from 17 to 48 now that I haven’t done while on warfarin. I just live life normally. Take as prescribed. Test regularly. Rinse and repeat.

 

[pellicle]

I’ll ask my wife if epinephrine could.

my quick search suggests nothing.

none the less the central thing is "self measure" ... gather data and actually know. All anxiety comes from fear, fear comes from ignorance. Once we can turn on the light we can see there are no warfarin monsters, only warfarin management issues.

Step 1: learn about this stuff
Step 2 do it without hesitation

Know Thyself

 

[almost_hectic]

I second that Tylenol has never been an issue. About the only thing I’ll take without running it by my pharmacist/wife first.

Tylenol fine. Aspirin or Ibuprofen not fine (according to my Dr.)

Although personally, Tylenol doesn't do anything for me. Ibuprofen however can be a lifesaver for me sometimes. So I only take it occasionally when its really needed.

 

[Sheenas7]

I recently asked my cardiologist what can I take when I pull a muscle in my back and really hurts besides Tylenol. He said I could do ONE dose of Advil when I first hurt myself ONLY.
Good to know. I have pulled a muscle twice lately.

 

[pedpatientmom]

I second that Tylenol has never been an issue. About the only thing I’ll take without running it by my pharmacist/wife first.

Thank you, Superman.

 

[Amy]

Funny how Tylenol is ‘a thing in nature’ in the context of this thread.

For anyone still interested:

“(There is) ..a clinically significant interaction between warfarin and daily use of acetaminophen 2-4 g.... Whether this interaction occurs when acetaminophen is taken in lower doses or is used sporadically requires further study.”

https://pubmed.ncbi.nlm.nih.gov/19779704/
https://pubmed.ncbi.nlm.nih.gov/17461702/
https://pubmed.ncbi.nlm.nih.gov/17145598/
https://jamanetwork.com/journals/jama/articlepdf/187300/joc71452.pdf
https://www.aafp.org/afp/1999/0201/p635.html
Table 3 in that last paper recommends:
“...to limit total acetaminophen dosage to less than 2 g per day; if higher dosages are used, increased monitoring may be necessary.” Simple enough. : )

 

[pellicle]

“(There is) ..a clinically significant interaction between warfarin and daily use of acetaminophen 2-4 g....

this is exactly correct

Whether this interaction occurs when acetaminophen is taken in lower doses or is used sporadically requires further study.”

not so much ... for example this post:

https://www.valvereplacement.org/threads/inr-and-paracetamol-todays-reading.43679/
this article:
https://pubmed.ncbi.nlm.nih.gov/17145598/
and also this article
http://www.medicine.ox.ac.uk/bandolier/booth/AF/paraod.html