Coumadin interaction

Posted by Bruce on June 13, 1999 at 10:29:58
Had surgery for aortic aneurism (aneurysm) two years ago and have St Jude's mechanical valve. Active in sports and recently reinjured knee. Will see orthopedic surgeon later this week. Been taking 4-5 mg/day coumadin and would like info on interaction of coumadin with the various anti-inflammatory meds he's apt to prescibe....thx

Posted by ccf cardio md - jmf on June 13, 1999 at 11:55:04
Dear Bruce,
Thank you for your question.  As you may know coumadin interacts with many medications including non-steroidal anti-inflammatory medications (NSAIDS) which is the likely class of medication you may be placed on after visiting your physician.  In general medications such as naproxen (naprosyn) and even tylenol have all been reported to increase your PT or INR.  
In general, as with any medication change, you should more closely moitor your INR following the addition of any new medication.  It is essential that your inr does not become too high or too low in view of your valve.  I would recommend a follow-up PT/INR within a week after initiating any new therapy including NSAIDs or sooner if you notice an increase in bruising or bleeding.  Please make certain that your physician is aware that you are on coumadin and require monitoring.
If you require surgical intervention, you will be required to hold your coumadin and be hospitalized for anticoagulation with heparin prior to surgery... but it does not sound like that will be the case!

I hope this has been useful. I wish you the best of luck. Feel free to write back with any concerns or more information once you have visited your physician.
Information provided here is for general purposes only. Specific questions should be addressed to your own doctor. If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter. The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.