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Antibiotics and Coumadin... INR 1.6...!!!???

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  • Antibiotics and Coumadin... INR 1.6...!!!???

    Well...I don't understand it. 2 weeks ago I was 1.8 on my home tester and 1.5 at the clinic. I admit ,I was eating a lot of salads and exercising a lot also.So we upped the dosage and I slacked off on the salads...10mg during the week and 7.5 on the weekends.Next test last Tuesday...2.1 ...better..and going up as it should.
    Today...1.6 on my home tester...wondering if i should go to the clinic for a confirmation.:confused:
    Here's the variable that was thrown into the mix on Friday...I had splinter in my finger that I couldn't get out last week ...By friday it was infected and swollen etc so i had to go to the doctor . She removed the splinter and thought it would be a good idea to put me on antibiotics because I was 10 weeks post OHS VR.
    Now the QUESTION ....Is the antibiotic(cephalexin)counteracting the coumadin and affecting my INR ???
    Or am I just some sort of freak ???;)
    Does 10 days worth of antibiotic therapy for an infected finger sound a bit excessive(I should probably go to the dentist while I'm on these antibiotics)
    Advice???
    Thoughts???
    Thanks ...Tim

  • #2
    I'd test again with the home tester. No way could it have dropped that much unless you missed a dose or two.

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    • #3
      I agree with Ross. Typically the antibiotics tend to raise the INR because they kill the Vit K producing bacteria in the intestines. Also, all antibiotics don't do the same thing. Amoxicillin is typically used for pre dental work protection.

      Comment


      • #4
        Thanks guys for your prompt response.
        Ross ,I went ahead and retested and this time it was 1.5.:eek: I sure don't remember missing a dose .I guess I will have to finally break down and buy one of those pill boxes that has the days of the week on it. I recall being 6 hours late one time but not missing any doses.
        Chris ,thanks for the clarification on the antibiotics.
        What next ????Check into the hospital??....take an early dose of coumadin???
        Where ya at big Al.??

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        • #5
          Your not living on 3 squares of spinich a day are you?

          It's not bootleg pills?

          Sudden increase in excercising?

          What are you putting in your stomach?

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          • #6
            Well, Deuce...

            I'd at least ascertain that the home tester is in good calibration.

            With those two mechanical valves in there the INR is a bit worrying. Perhaps a trip to the clinic is in order. Take the tester with you and have them test at the same time as you do. Err on the side of caution.

            And I agree that antibiotics tend to raise the INR for most people. Either that or it has no effect which, so far, is the case with me.

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            • #7
              Originally posted by Deuce
              Thanks guys for your prompt response.
              Ross ,I went ahead and retested and this time it was 1.5.:eek: I sure don't remember missing a dose .I guess I will have to finally break down and buy one of those pill boxes that has the days of the week on it. I recall being 6 hours late one time but not missing any doses.
              Chris ,thanks for the clarification on the antibiotics.
              What next ????Check into the hospital??....take an early dose of coumadin???
              Where ya at big Al.??
              Tim:

              At 10 weeks post-op, you're still going to be unstable at times. As you recover, you'll become more active, needing more warfarin. So your INR will drop because your metabolism is speeding up.

              I hated having to get one of the weekly pill boxes, because I thought it made me look like a little ol' lady getting it out at breakfast in a restaurant. Then I thought, Whattheheck? It keeps me alive.
              Those pill boxes do come in handy. Much easier to know if you've taken your rat poison than to try to remember.
              Marsha (7-28-50), MVP 1990/MVR (St. Jude) & ASD repair 6/24/03 Baylor University Medical Center, Dallas Texas. Hometesting since 11/03, first with ProTime 3, now with INRatio.
              John (3-13-46), MV repair 5/10/07, Dallas Presbyterian, port-access incision, Dr. William Ryan. Chordae ruptured 12/05 in car crash.

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              • #8
                Exercise??? No increase but i did jog for a bit yesterday evening which i hardly ever do .
                Put in my stomach??? I did have a nice Greek salad last night but as i said before i have slacked off on my salad/greens intake ...:confused: Ohhhhh BINGO.... I have been taking a protien supplement ...
                EAS 100% Whey Protien... what do you think??? Whey protien isolate/concentrate. with acesulfame potassium. Branch chain amino acids . No vitamin K.
                Do any of those sound like the culprits???
                That has to be it . I just bought it and started using it last thursday.
                Obviously I won't be able to take that anymore.
                What do you folks think ??? Mystery solved ???
                Advice,Thoughts,Comments.
                Thanks .
                Tim

                Comment


                • #9
                  Tim:

                  What are the exact ingredients in the drink? It's only going to list Vit K in the ingredients if it's an ADDED supplement. If something has spinach, broccoli, asparagus, etc., it's not going to have Vit K listed in the ingredients because the vitamin is not what's being added.

                  I'm sure that Al will check in when he has time. Don't know if he checks in during the workday while at work.
                  Marsha (7-28-50), MVP 1990/MVR (St. Jude) & ASD repair 6/24/03 Baylor University Medical Center, Dallas Texas. Hometesting since 11/03, first with ProTime 3, now with INRatio.
                  John (3-13-46), MV repair 5/10/07, Dallas Presbyterian, port-access incision, Dr. William Ryan. Chordae ruptured 12/05 in car crash.

                  Comment


                  • #10
                    The ingredients :
                    Protien Blend(Whey Protien Concentrate and Whey Protien Isolate),Natural and artificial flavors,acesulfame potassium and sucralose.
                    Some supplement facts: (or i should say ...alleged supplement facts).
                    Protien 23g
                    Calcium145g
                    Iron< 1mg
                    Sodium 50mg
                    Potassium 170mg
                    Not a significant source of Vitamin A and C.

                    I seem to recall that soy products affect INR and I'm pretty sure this "whey protien" is derived from soy.
                    Comments,Thoughts.
                    Tim

                    Comment


                    • #11
                      Whey comes from cows milk...no soy there

                      We had a discussion about this some time ago.
                      I was of a mind to try it then, but didn't.
                      I may just do that now.
                      Hope this helps.










                      --------------------------------------------------------------------------------

                      Sharon:
                      Whey protein is protein from cows milk, which shouldn't be a problem for you. Actually, if you read some of the articles on the link left here, you might find that you have the potential for doing yourself alot of good with whey products. Apparently, the American Heart Association thinks hightly of whey too. I would be careful about the other ingriedents in protein shakes though. As others have stated, some shakes include soy as well as whey. I wish I knew all of the different names used for soy products. Perhaps someone can help on that. I have included a link that has some interesting materials under news. Hope it helps.
                      http://www.wheyoflife.org/
                      Blanche
                      PS Was little Ms Muffett eating cottage cheese? (curds and whey)

                      Comment


                      • #12
                        Duece - Whatever is causing it needs to be counteracted. I'd bump my dose up by 10% and test again in 4 to 5 days. Gotta get you in range my friend.

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                        • #13
                          Believe me Chris...I was tempted to go ahead and take my meds early... and an extra 2.5 mg at that...had 'em in hand and decided not to rush things ...just wait until the regular time...around 6pm.
                          So after conferring with my "coumadin manager" I took an extra 2.5 today(12.5 total) and will take 10 the rest of the week and test again on Friday.
                          I have an appt with my cardio on friday and they will start managing my coumadin there.
                          Thanks for the info on "Whey" Blanche.I should have known it couldn't be soy . They weren't into soy back in Ms. Muffets time ;) .

                          Comment


                          • #14
                            Whether you are "exercising" or not, your need for more Coumadin will most likely increase some as you heal. Your body gets thrown for a loop with OHS and efficiently finds ways to back down from the usual pace in order to heal. I didn't have the energy to exercise for at least a year after my surgery, but my warfarin dose increase gradually for quite a while. I'm thinking you may just be at one of those times when your dose needs to be bumped up to the next level. You are taking a pretty large dose for someone 10 weeks post-op. Your metabolism may just be faster than most. Are you someone who has always been able to eat what you want without thoughts of gaining weight? (Just a thought.)

                            I agree with Chris - regardless of the reason for the low INR - you need to increase your dose.

                            Comment


                            • #15
                              My INR ALWAYS decreases with antibiotics. I will see a spike in the INR with consistant exercise.
                              All the best,
                              LuvMyBirman :)
                              MVR, 3/99

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