I included the link because it gave some of the formulations of Excedrin on the market:
* Excedrin Tension Headache Contains 500 mg acetaminophen and 65 mg caffeine.
* Excedrin Sinus Headache Contains 325 mg acetaminophen and 5 mg phenylephrine HCl as a decongestant.
... which it would seem contain no aspirin. So check the package.
Here in the US, "Extra Strength" (the original) and "Migraine" (same formula, different label) are the varieties that most people are familiar with and likely to take and do contain aspirin.
As to Aspirin being a problem, well I'm not a pharmacologist or a pharmacist, but from what understand it all things it depends on issues of dose intensity and regularity (as well as other factors).
I am on Aspirn (50mg) as a daily dose on instructions from my surgeon, on a thread here I noticed that others take 100mg daily.
(for instance
http://www.valvereplacement.org/forums/showthread.php?24678-coumadin-and-aspirin )
I had never routinely taken aspirin but the hospital sent it home with me after surgery. When my cardiologist found out about it, he was surprised and advised me to discontinue it immediately. Maybe it is related to the fact that I have no artery disease or blockages, which I understand is usual reason for daily aspirin regimen.
I agree, and that's why I said it shouldn't be a problem but added in the other bits about 'chronic' usage acting as effecting the INR:
but added the clarifications to make it clear that it required chronic usage (long term) and probably high levels. For instance my Dad (not on warfarin) was taking 2 650mg tablets 4 times a day for back pain. That would perhaps effect his INR.
I generally take what I would consider to be a reasonable approach and not use OTC medication such as Excedrin as a long-term, daily drug. To me, that kind of treatment is for prescription medications and doctor supervision. OTCs should be used for minor, short-lived problems, like a headache or an allergy season. If I had the kind of chronic pain that would require taking 8 tablets a day for an indefinite period, I would surely talk to my doctor about it.
I did not know about the effect of acetaminophen on INR, but did know about the potential for serious liver damage, which would apply whether one is taking warfarin or not. I still feel comfortable with my pharmacist's advice that occasional use of acetaminophen would not be a problem.
And, according to the table you quoted, aspirin does not increase INR, but
does increase bleeding risk, which to me is what really matters. Keep in mind that your specific use of aspirin is a regular low dose as prescribed by a doctor, not the 1000mg doses I've taken in my younger days to try and fight a bad migraine. You take 50mg per day, but two Extra Strength Excedrin contain 10 times that much.
Whichever way you come to it, we can all agree that taking too much Excedrin is a pretty bad thing for those of us on warfarin.
(Protimenow: I agree, stomach bleeding while on warfarin -
major problem.)
