warfarin-acetominophen interaction

[Marty]

The conventional wisdom is that there is little or no interaction between Tylenol and warfarin. This is a personal anecdote for the record. On November 1 ,I started taking two Tylenols( 1000 mgm) at night. In addition to everything else, I have "muscular rheumatism" polymyalgia rheumatica and I thought Tylenol might help the prednisone and l-thyroxine already prescribed. I seemed to sleep better and have less pain. My INR on
Nov 1 was 2.0. I raised my weekly dose from 20 mgm to 23 mgm. I tested today November 17 and my INR was 4.7! I'm stopping Tylenol, holding warfarin one day and then taking 2.5 mgm /day until Saturday November 22 when I will test again. For years I have had a stable INR around 2.5 + or - .5, taking around 21 mgm/week. I can only attribute the INR 4.7 to Tylenol. My advice is that any one beginning Tylenol and regularly taking 1000 mgm per day or more, check their INR weekly to see if they are interacting .According to the literature, 1000 mgms should have no effect, but there are "individual variations".

 

[Bina]

Hello marty,
I am also on a low dose....I take 19 mg per week.
Once I had an INR of 4.2 and all I did was take 1/2 dose for one day. No holding necessary.
Your 4.7 is nothing to panic about.....Maybe the prednisone is at fault?
I've heard that very high doses of Tylenol can affect the liver where Vit.K and warfarin are processed.
Sorry, I don't know more than that.

 

[LUVMyBirman]

It's a possibility. Did read somewhere that Tylenol on a consistant basis could raise the INR. I have found that Tylenol with Codine and Vicodin (which has codine in it as well, yes?) Lowers the INR.

Marty, hope you find a good combo and get to feeling better. Wish they would come up with a anti-inflamatory that did not interact with the Coumadin! I have been on Prednisone short term. That alone did the trick.

 

[Ross]

I'd blame the Prednisone myself. There's always a first, but I really think it's the steroid.

 

[dick0236]

I have taken 1000mg Acetominophen daly for the past couple years for spinal pain and have had no interaction with Warfarin.

 

[chinita]

I'd blame the Prednisone myself. There's always a first, but I really think it's the steroid.

I'm with u ross, I too think it's the steroid........... last year I got bells palsy
and took prednisone ,I was very closed monitored cause my INR flew up like a rocket!!

 

[terodac]

Tylenol is a blood thinner! along with your other blood thinner maybe you need to adjust. Ask your doctor, I was told not to take a lot of tylenol just when I need it I have only had one in two years. My topral xl takes away any headace I get.

 

[catwoman]

Tylenol is a blood thinner! along with your other blood thinner maybe you need to adjust. Ask your doctor, I was told not to take a lot of tylenol just when I need it I have only had one in two years. My topral xl takes away any headace I get.

http://www.warfarinfo.com/New_Folder9/acetaminophen.htm

According to Al Lodwick's website, you would need to take 26 regular (325mg) or 19 extra-strength (500mg) tablets per week to see an increase in your INR. (Based on studies)

I take extra-strength Tylenol. Have not seen an increase in my INR due to it.

 

[Bina]

I don't think that Tylenol falls into the "blood thinner" category.
My docs said it was safe with warfarin/Coumadin....but to watch out for excessive use of Aspirin.

 

[Ross]

Tylenol is a blood thinner! along with your other blood thinner maybe you need to adjust. Ask your doctor, I was told not to take a lot of tylenol just when I need it I have only had one in two years. My topral xl takes away any headace I get.

Get that evil word "thinner" out of your vocabulary right now. Anticoagulant is what the word should be. Your blood is not thinned, it is simply inhibited from forming clots.

 

[Marty]

prednisone?

prednisone?

I've been on prednisone for a little over a year now. I started at 10 mgm. For the last couple of months the rheumatologist decided to taper me down so I'm at 2 mgm a day now.the prednisone never interacted with the warfarin in my case. However the Tylenol did. I reviewed the literature and in most people Tylenol even in high doses doesn't cause any problems. However the articles all have the caveat " all patients differ ,so check INR frequently when starting Tylenol"