Z pac and INR

[Mileena46]

I have some swollen sinus glands in my neck, and the clinic gave me a Z Pac, haven't started it yet because I think I remember reading that it will mess with your INR levels. Since the clinic who does my testing is Coumadin challenged and stated it would make no difference to my intake....can you guys help? I tested one week ago Tuesday (one week 3 days) with a reading of 2.0. Nurse called to tell me all was well and stay on the same dosage, (I should be 2.5 to 3.5) I questioned her....did NO good. My dosage was: 5 mg 5 days and 6 mg 2 days. (BTW this was second low reading this month...was 2.3 last time.) I upped my dose to 6mg every other day. They don't want me to do that, but I am scared. NOW I need to take this Z Pac but am worried it will lower my levels even more. Any advice??

Mileena

 

[catwoman]

According to the packaging insert for Coumadin

http://packageinserts.bms.com/pi/pi_coumadin.pdf

azithromycin (Zithromax or Z pac) will increase your INR.

Those who have their own testers generally test before initiating a course of antibiotic or other RX that might increase the INR. Sounds like you do not home-test, though.

If I were going on a Z-pack, I would probably test before starting, to make sure I was in range. And then just take the 5 or 6 tablets and not worry, since it's a short-term course and your dose would start to come down shortly afterwards.

One point: Medical professionals have told me that azithromycin has become so routinely prescribed that bacteria are becoming resistant to it.
My dad gets upper respiratory infections very easily because he has pulmonary fibrosis. His family doctor RXes a Z-pack by phone, and if it doesn't work, it's a 2nd Z-pack. Which doesn't work either. (My sister & I -- the POAs -- aren't happy that a Dr. will RX by phone w/out seeing a patient who has several major health issues, but we can't be there all of the time.)

So ... if one course of azithromycin doesn't work, ask your doctor about switching to another antibiotic for the next go-round.

 

[Mileena46]

Thank you Marsha...so if it increases my INR and I have also increased my dose (without the clinic telling me to) then I am in trouble. I might do better not taking my Z!

Mileena

 

[drivetopless]

I was on Bactrim 5 days and it increased my INR to 4.6, so antibiotic will make your numbers higher, not lower. After stopping Bactrim, INR is back in lower range. So, it should be a temporary increase for you on the Z-Pac.

 

[ALCapshaw2]

I've taken a Z-pak a couple of times and didn't have any problems staying with my normal Warfarin dosing.

To be safe, it wouldn't hurt to check your INR after about 4 days and then maybe another 4 to 7 days.

 

[Bina]

Thank you Marsha...so if it increases my INR and I have also increased my dose (without the clinic telling me to) then I am in trouble. I might do better not taking my Z!

Mileena

I wouldn't worry so much. If you take the Z and it ups your INR a bit, that is going to be fine because it appears
that you are due for a little bump up in your dosing anyway.