When to anticipatory test ?

[ccrawford]

From time to time, some of us have to change meds or add a med to our pill box. Some of these meds (actually a lot of them) interact with Coumadin. My question: I routinely do a home test the day I start a new med, and I usually figure I should test again in about a week to see what the new med did to my INR. If the data sheet on the new med is particularly scary, I'll test in 4 or 5 days. One source of advice says test again in 4 or 5 days. Another says test again in about two weeks. I have not found this topic covered anywhere. Whattya think ? Chris

 

[Ross]

If it were I, I'd do the samething especially if the sheet makes a point of a decent interaction with Coumadin like what you'd see with Clarithromycin ect. This should be interesting.

 

[Guest]

I think that you are right on target Chris.

 

[ccrawford]

Tested today and got a 2.5. Hmm - The new cholesterol med was supposed to accelerate the INR and I went from a 3.0 to a 2.5. Wonder what the effective time period is for Crestor - the data sheet doesn't say anything. Guess I'll bump my dosage a little and test again in a couple of weeks ??

 

[Guest]

I talked to the sales rep for Crestor last week and not much is really known about it. There are some reports of other drugs in the same class interacting with warfarin, so the FDA may consider this a class effect warning when Crestor may not really do anything.

 

[ccrawford]

Update on Crestor effects

Update on Crestor effects

I tested today, and I'll be darned if my INR hadn't climbed to 4.6. Just to clarify, I started a new cholesterol drug (Crestor) on 10/26 when my INR was a perfect 3.0. The data sheet warned of
warfarin interaction so I tested a week later and found my INR had dropped, not risen, to 2.5. Three and a half weeks later, I find it at 4.6. Hmmmm - Maybe it takes awhile for the Crestor to kick in? Al - If you talk to your Crestor rep, let him know about this. I'd be curious to hear the reply. Maybe Rain's dog is digging in the garden again !

 

[Ross]

It's all that stress from hunting them quail!

 

[Guest]

He's a she.

The INR slightly above 4 does seem to be what you would expect. My guess is that it does take a while for it to happen. Your experience is probably more valid that what the rep has been told to say. I'll send her an e-mail with your experience and put it on my website.

 

[ccrawford]

Thanks Al - I wondered about that. I bet it takes at least a couple of weeks for the Crestor to build up in the system like most lipid drugs. If that's the case, then Coumadin users need to watch out for the two to three week effects. Ross, Quail hunting is a panacea for all that ails ya, not a stressful process, but a soothing one that you can have nice dreams about. One of the most beautiful things in the world to watch is a couple of good bird dogs working a good quail patch - When one finds a covey, then the other goes on a backing point. You walk in and there they are. They flush and you get off a couple of good shots, maybe three if your using an automatic. One of your dogs needs to be a good retreiver of dead birds. The call goes out - "Dead bird" and the retreiver kicks in high gear. Before long, you have all your birds in the pouch and you walk on to the next area. You love it, the dogs love it, and your wife loves to fix a big mess of quail for supper. It doesn't get too much better than that. Besides the good exercise, you get to splurge on a sinfully good breakfast at some local restaurant that serves a bunch of good saturated fat stuff. Chris

 

[Guest]

Chris,

I posted your levels on my website at http://www.warfarinfo.com/rosuvastatin.htm

As far as I know, this is the first report of this online and there are certainly none in medical journals yet.

 

[ccrawford]

Thanks Al - Gee I knew I'd make the history books somehow !

 

[Ross]

Chris you make it sound just as I remember it and your tempting me highly to come visit you and attempt to experience it once more. I know I'd never make it to the field, but man it sure sounds great. There are a lot of things I miss being able to do.