Warfrin and Anti Inflammatory Drugs

[Cooker]

Is anyone taking Warfrin and Anti Inflammatory Drugs (Rx, OTC)? ... I have been told I can't go on anti-inflammatory meds and should not take OTC (Aleve etc) because of gastric bleeding possibilities ... Just how probable is a gastric event? ... I'm taking Aleve when I can't take the pain ... I don't take it everyday (maybe twice a week) and when I do I usually only take one ...

Thanks....

 

[KristyW]

Cooker,

I take what works. I do not have any gastric issues, so the occasional ibuprofen or naproxen sodium is what I take for bad headaches and muscle aches. The problem I have with Acetaminophen is that it doesn't work AND it's VERY HARD ON THE LIVER. My understanding the Celebrex can be prescribed for patients on warfarin, but it has it's own risks too (plus it's not cheap)

 

[Freddie]

Sorry I can't give any advice Sir Cooker, I use A535 when need be, which is seldom. It's a cream and only use a tiny tab cause it does throw out my INR.

Hope your pain doesn't worsen.

 

[Bina]

Cookie needs a hot tub

 

[sweetmarie]

What a coincidence. I was going to ask the same question. I put my back out on Friday and the pharmacist told me I could take Robaxacet for pain (I was having spasms and going out of my mind). Today the nurse came to the house (have trouble walking with sore back) to draw blood for my INR. She told me acetaminophen was not good with coumadin, would increase INR. I asked what can I take to relieve the pain, I needed something. She then said that acetaminophen was the better of all the worse, didn't mention the liver but I'm not planning on living on it, at least I hope not. Took about 15 tablets since friday
Grrrr, 52 years old and going on 90!!!!

PS: Just got my INR result for this morning, 2.34 (my range is 2.0-3.0). Go figure.

 

[yotphix]

I have also been prescibed Naproxen and it has worked for my neck pain, without affecting my anti-coagulation in any noticeable way. It does mess with the results of liver enzyme tests. I don't believe that it matters much except that it might alarm a doctor and get you sent for unnecessary further testing.

 

[Cris N]

I use naproxen sodium on a regular basis during the summer so I can play golf. I haven't had any issues with bleeding... at least so far. My doc would probably have a fit but what he doesn't know won't hurt him.

 

[catwoman]

Cooker:

I've been taking Alleve (naproxen) lately (2 tabs a day, not always daily). Works much better for me than acetaminophen or Advil.

 

[ALCapshaw2]

What a coincidence. I was going to ask the same question. I put my back out on Friday and the pharmacist told me I could take Robaxacet for pain (I was having spasms and going out of my mind). Today the nurse came to the house (have trouble walking with sore back) to draw blood for my INR. She told me acetaminophen was not good with coumadin, would increase INR. I asked what can I take to relieve the pain, I needed something. She then said that acetaminophen was the better of all the worse, didn't mention the liver but I'm not planning on living on it, at least I hope not. Took about 15 tablets since friday
Grrrr, 52 years old and going on 90!!!!

PS: Just got my INR result for this morning, 2.34 (my range is 2.0-3.0). Go figure.

Something is NOT right here. It is my understanding that Tylenol (acetaminophen) IS the recommended Pain Reliever for patients on Coumadin. (and YES, it is less effective than most anti-inflamatories at relieving pain)...

'AL Capshaw'

 

[dick0236]

I have taken acetaminophen for over 30(?) years with my docs knowledge and approval, both GP and Cardio. For the last few years, I have taken two 500mg tabs nightly for spinal pain....yeah, it is hell to get old. The max daily dose is eight 500mg tabs daily per the drug bottle. This drug has never affected my INR. I have been told by my docs to never take Asparin. I have, on a few occasions had doctors prescribe some pretty potent "pain killer" for very short periods. Actually, I get pretty good relief from the acetaminophen......and regular gym visits also help with my aches and pains:smile2:.

 

[sweetmarie]

Something is NOT right here. It is my understanding that Tylenol (acetaminophen) IS the recommended Pain Reliever for patients on Coumadin. (and YES, it is less effective than most anti-inflamatories at relieving pain)...

'AL Capshaw'

You are correct. I should have been clearer. What I meant she said that while acetaminophen is not "good" for coumadin users, it use the logical choice (the lesser of all evils). Sorry for the confusion.

SM

 

[WandaW]

This has been a frustration since I had my OHS about 8 weeks ago. I have osteoarthritis in both knees, they need to be replaced, but not this year. I now take the Arthrits strength Tylenol and it helps but not like my prescription slow release 800 mg Ibuprofen. The prescription Ibuprofen was easier on my stomach then the OTC Ibuprofen.

 

[Protimenow]

It scares me that you're taking those chronic doses of Tylenol. I've found an OTC medication that's a version of what they apparently use to reverse some of the liver damage that Tylenol causes. It's called NAC (the abbreviated name), and may provide protective effects. NAC is a precursor to glutathione, and is useful for a variety of things - including liver damage and some inflammatory lung problems. My wife started using it (not for any liver or lung problems) and has found some rather amazing benefits. Before using it, of course, you should read about it and learn more before using it.

My wife and I are now both using it (but NOT Tylenol), and our lungs feel clearer, and other problems seem to be resolving. Your research will probably show that NAC is good for reversing liver damage caused by Tylenol, and you should consider taking it along with Tylenol. (Don't take NAC at night -- it clears the mucus from your lungs, and you may wake up a few times clearing the gunk out)

Again - this is something that you will have to decide whether you try it or not, but there's a lot of information on the Internet regarding NAC.

 

[carolinemc]

I just looked up NAC and you should talk to your doctor before taking anything like this. It is for specific use, it could affect warafin-coumadin. Be sure to check any medication for affects to warafin-coumadin. It could affect the INR. Just to be causious. There are a lot of hocus pocus otc that have no real power to cure all things. Be careful.

 

[Herb M]

If you read enough, you will find that almost everything interacts with coumadin/warfarin. Unless I am taking large doses for a long time, I do not worry about it. If I checked my INR everyday or two, I probably would see a change. I only check every 4 to 6 weeks and of course I see no change. I am adverse to taking prescription medicines. I only take coumadin and before a dental visit I take amoxicillin. I do take supplements and food that is said to interact with Comadin, but so what.

The most famous food that is said to interact with Coumadin is greens. You all know about it but most of us pay no attention and eat what we want and adjust our dose as needed.

 

[Protimenow]

Carolinemc -- one of the SPECIFIC uses for NAC is to reverse liver damage caused by Tylenol. And, no, it's not THAT specific. I've been taking warfarin for nearly 20 years, and I DO check for interactions with warfarin for ANYTHING I take. I found no information about interactions, no contraindications, and haven't seen any effect on my INR since I've started taking it.

I AM cautious with what I take.

Since I began taking it, my allergies to pollen seem to have disappeared (I just cut a lot of green stuff - including weeds - outside, and so far I have NO problems with the stuff I inhaled); the stuff has done some tremendous good for my wife, easing some of her muscular pains. I realize that a lot of the OTC stuff is worthless. I also realize that a lot of the OTC stuff (like Tylenol) can be extremely dangerous. My wife are taking NAC twice a day - 1200 mg total for the day - and will continue taking it every day -- the 'specific uses' you mention include things that daily doses of NAC will help with. I haven't found any changes in my INR because of NAC.

If you do more checking about NAC, you'll probably find more information that should make it seem less dangerous than you're assuming.

I didn't say NOT to ask a doctor about anything you add to your medications -- it would be nice if doctors knew more about some of these things we take (including warfarin, in many cases) -- but with someone saying that they'll be taking Tylenol regularly - and with NAC being used to reverse the damage to the liver that is caused by Tylenol - I thought it a good suggestion to try to avoid the damage from Tylenol before it actually occurred.

 

[WandaW]

I continue with my Chondroitin/Glucosamine and Omega 3 as I did before my surgery with my MD's approval. These do help with some of the joint pain and stiffness. I am allowed to recieve cortisone shots in my knees if I wish, havem't done that yet since my OHS, may do that soon so I can keep up with the spring amd increase my walking. I think my vitamins do keep me running smoothly, however I am new to Coumadin and I am grateful they have a drug to prevent a stroke especially with the Atrial flutter I have experienced. My Surgeon said they are working on better anti-coagulant drugs with so many people needing them now, I hope in a few years we will have something that is easier to manage, I do keep some OTC Ibuprofen around for a BAD headache, Aleve does upset my stomach. The prescription Ibuprofen is easier on my stomach. I think I am just tired of hurting some days.

 

[Protimenow]

Warfarin has done a pretty good job over the years. It's the biggest problem when those who use it don't test regularly enough, and when they vary widely in diet and activities. It's a problem if the professionals who are supposed to be managing anticoagulation do such a crappy job. People don't complain about insulin being such a defective remedy for diabetics -- but diabetics are allowed to self test more often than is necessary, and they're able to self treat with insulin or glucose (if they experience major hypoglycemia). If those taking warfarin were allowed to - or even encouraged to - test once or twice a week and to carefully regulate dosing, as has been proven in many studies, THEN warfarin wouldn't be such a scary drug. Once regulated, most people don't need to make any changes (and certainly nothing drastic) to minor fluctuations in INR -- regular, more frequent (than bi-weekly or monthly) testing, and intelligent response to fluctuations in INR would make this dime a day drug and INR easily manageable.

Of course, the 'convenience' of another drug that will probably cost $8 or $9 a day, but require less testing may be attractive to some people (and certainly to the drug companies and physicians who don't want to have to worry about patient compliance with warfarin dosing). Comparing $8 a day to about a dime or so a day certainly argues for the suitability of warfarin for a vast majority of users -- if they're able to frequently test their INRs and make minor dosing adjustments when necessary.

I don't see Warfarin as all that bad.