Ross
Well-known member
WARNING: BLEEDING RISK
Warfarin sodium can cause major or fatal bleeding. Bleeding is more likely to occur during the starting period and with a higher dose (resulting in a higher INR). Risk factors for bleeding include high intensity of anticoagulation (INR>4.0), age >65, highly variable INRs, history of gastrointestinal bleeding, hypertension, cerebrovascular disease, serious heart disease, anemia, malignancy, trauma, renal insufficiency, concomitant drugs (see PRECAUTIONS), and long duration of warfarin therapy. Regular monitoring of INR should be performed on all treated patients. Those at high risk of bleeding may benefit from more frequent INR monitoring, careful dose adjustment to desired INR, and a shorter duration of therapy. Patients should be instructed about prevention measures to minimize risk of bleeding and to report immediately to physicians signs and symptoms of bleeding (see PRECAUTIONS: Information for Patients).
From the prescribing info pamphlet:
Elderly: Patients 60 years or older appear to exhibit greater than expected PT/INR response to the anticoagulant
effects of warfarin. The cause of the increased sensitivity to the anticoagulant effects of warfarin in this age group
is unknown. This increased anticoagulant effect from warfarin may be due to a combination of pharmacokinetic
and pharmacodynamic factors. Racemic warfarin clearance may be unchanged or reduced with increasing age.
Limited information suggests there is no difference in the clearance of S-warfarin in the elderly versus young
subjects. However, there may be a slight decrease in the clearance of R-warfarin in the elderly as compared to the
young. Therefore, as patient age increases, a lower dose of warfarin is usually required to produce a therapeutic
level of anticoagulation.
To sum up what this says, if you keep your INR in range and are compliant with such, your not elderly, don't have ulcers, etc, you should be safe and able to do whatever you wish with common sense. Just because you take Coumadin does not suggest that you are going to blow up into a massive explosive ball of hemoglobin as so many of the papers, hearsay, and myths say to you.
This is a public service announcement brought to you courtesy of me.
Warfarin sodium can cause major or fatal bleeding. Bleeding is more likely to occur during the starting period and with a higher dose (resulting in a higher INR). Risk factors for bleeding include high intensity of anticoagulation (INR>4.0), age >65, highly variable INRs, history of gastrointestinal bleeding, hypertension, cerebrovascular disease, serious heart disease, anemia, malignancy, trauma, renal insufficiency, concomitant drugs (see PRECAUTIONS), and long duration of warfarin therapy. Regular monitoring of INR should be performed on all treated patients. Those at high risk of bleeding may benefit from more frequent INR monitoring, careful dose adjustment to desired INR, and a shorter duration of therapy. Patients should be instructed about prevention measures to minimize risk of bleeding and to report immediately to physicians signs and symptoms of bleeding (see PRECAUTIONS: Information for Patients).
From the prescribing info pamphlet:
Elderly: Patients 60 years or older appear to exhibit greater than expected PT/INR response to the anticoagulant
effects of warfarin. The cause of the increased sensitivity to the anticoagulant effects of warfarin in this age group
is unknown. This increased anticoagulant effect from warfarin may be due to a combination of pharmacokinetic
and pharmacodynamic factors. Racemic warfarin clearance may be unchanged or reduced with increasing age.
Limited information suggests there is no difference in the clearance of S-warfarin in the elderly versus young
subjects. However, there may be a slight decrease in the clearance of R-warfarin in the elderly as compared to the
young. Therefore, as patient age increases, a lower dose of warfarin is usually required to produce a therapeutic
level of anticoagulation.
To sum up what this says, if you keep your INR in range and are compliant with such, your not elderly, don't have ulcers, etc, you should be safe and able to do whatever you wish with common sense. Just because you take Coumadin does not suggest that you are going to blow up into a massive explosive ball of hemoglobin as so many of the papers, hearsay, and myths say to you.
This is a public service announcement brought to you courtesy of me.
