Warfarin and Orange Juice

[Mileena46]

I have researched on the net the interaction between OJ and Warfarin levels and there are none. I did find a connection with Grapefruit and grapefruit juice. I never drink OJ unless I am sick and every single time I drink it for several days in a row my INR bottoms out. In one week I went from 3.9 to 1.9...with the ONLY difference being OJ. This is the second time this year. The first time I put it down as a fluke, now I am wondering.....my dose has been the same for a couple years with very few out of range episodes. I am convinced it was the OJ! Before you ask....I took no meds....for the cold....nothing...scared to, I just tough it out. I can honestly say.....there was no difference in my diet.....or level of activity...unless it was less activity which should have the opposite effect, but since I don't have an exercise regime that should have been insignif! Am I the only one that OJ affects???

 

[marc_kowal]

I've never heard of orange juice affecting INR levels. From my personal experience, OJ has no effect on my INR. Sometimes I'll go weeks without having a glass and then other times I'll have 1-2 glasses a day for a few days, No impact on my INR. Perhaps just from being sick, your metabolism is affected and is having an effect on your INR. Just a thought.

 

[Protimenow]

I avoid grapefruit juice. I don't know if there are similar components in orange juice. Since my TIA, as part of a stroke protocol, I'm taking Lipitor - although my cholesterol was OK before the TIA.

At one time, I was taking Quercetin, which is derived from citrus, and it seemed as if it may have confused my InRatio meter -- my actual INR was much lower than the meter reported.

On the whole, though, I have doubts that orange juice has any/much effect on INR. (Of course, if you have TOO much, and get a gastric bleed as a result of the acid, this may have some effect)

 

[pellicle]

Hi

...I never drink OJ unless I am sick and every single time I drink it for several days in a row my INR bottoms out. In one week I went from 3.9 to 1.9...with the ONLY difference being OJ

well ... and you being sick ... I find that being sick or even starting training hard (instead of not training at all) makes significant differences to my INR and I only require minor dose adjustments.

Am I the only one that OJ affects???

its possible you are, but that's not important. Whats important is that you know it and know what to do about it. It could be that there are some other citrus juices in there, as there is a spanish orange which also effects INR

Also Vitamin C may have an effect too ... is this pure juice or has it been enhanced (you only know its pure if you squeeze the oranges)

http://www.ptinr.com/warfarin-you/drug-other-medications/natural-medicines-vitamins/vitamin-c

 

[tom in MO]

I don't believe it has to do with your OJ, unless it is fortified with vitamin K. It probably has to do with a change in your metabolism due to stress (the cold) or the cold itself. Both of these can affect your INR.

 

[Aggie85]

Just looked up the Quercetin that Protimenow mentioned. It looks like something none of us on Warfarin should take. It's in green tea anyway, and I was told green tea is like grapefruit juice, a NO NO don't go near. Anyway, warfarin wasn't specifically mentioned but the Quercertin affects MANY liver enzymes. It's the liver enzyme issue which affects warfarin metabolism when taking grapefruit juice, mangoes, and star fruit (which I discovered in Mexico and then found out should NOT eat). To rule out OJ vs cold. After you're better and not sick, try drinking the same amount of OJ and see if it affects your INR the same. Eliminate out the variable of the cold and then retest. Hope you're feeling better soon!