These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.
Coumadin
Question: My 86 year old aunt has been on Coumadin for the past 6 months and claims she feels like death warmed
over since she’s been on this drug. Is there
a special diet she should be on? Are there any side affects with this drug? To
this point she has been a very healthy person, but for most of her life
she has had heart flutter. That is the reason the doctor put her on this drug.
Answer: Coumadin rarely causes side effects. Why is she taking the drug? I suspect the medical
condition that requires her to take the drug is the reason that she feels so poorly. There is no
logical reason that her physician would suddenly start the drug without a change in her
cardiac rhythm. I suspect that her rhythm is changed resulting in the change in her affect.
Coumadin
Question: My husband’s doctor just prescribed “coumadin” for him without even doing
a blood test. He is taking a low aspirin dose every day and is leery of
taking the coumadin. He is 73 and takes lanoxin and calin.
Answer: There are several reasons to take coumadin. However, these should be discussed with the patient and the risks and benefits should be explained. There is always a risk of bleeding with coumadin. Your husband needs to understand why he is taking this drug and what benefit the physician expects. Usually blood tests are not done until the patient is on the drug for a week or so. Then they should be done regularly (depending on how much variation is seen in his test from weekly to every 2 months).
Coumadin
Question: My mother is currently taking Coumadin. Is there a restriction of green vegetables
while on this drug? If so, could you send me a list of the ones she should
avoid? The drug has saved her life and stopped her stroking, but she also has bowel
problems and must eat a lot of fiber.
Answer: There are a lot of medicines to avoid or to be careful taking with coumadin, but green vegetables are not one of them.
Coumadin
Question: My Dad was prescribed coumadin after his by-pass
surgery recently. Specifically, which foods must he
stay away from. Green, leafy vegetables is one type, but
what else? Should he stay away form Grapefruit?
Answer: Green leafy vegetables are of no concern. There are many medications which can interact and any new medication should be discussed closely with your physician and pharmacist to determine the effect. For practical purposes, regular monitoring will reduce the risk of bleeding, which is about 5-10% per year.
Coumadin & Floxin
Question: Is there any interactions when taking Coumadin and Floxin which would increase the INR level?
Answer: Coumadin(warfarin) is an anti-coagulant used in a variety of situations to decrease the ability of the body to form clots. It acts on different “factors” in the blood necessary to start the coagulation cascade. These factors are made in the liver. Consequently, any drug that is metabolized in the liver can affect the level of coumadin in the body and the subsequent INR. INR is a measure of the decreased coagulation ability of the blood. Coumadin was initially discovered at the University of Wisconsin as a rat poison. As you can see too much of this drug will ruin your whole day. Therefore, it is very important that all your physicians and your pharmacist know that you are on coumadin. In general, antibiotics must be followed extremely closely to avoid either too much or too little coumadin. Floxin(ofloxacin) belongs to a class of drugs called quinolones. These drugs in general increase the effect of coumadin;that is, taking floxin will require your coumadin dose to be decreased. However, this is a very individual effect and must be watched by more regular blood tests to test the effect of coumadin while and immediately after taking the antibiotic.
