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Coumadin and Fruit

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  • Coumadin and Fruit

    Is there any fruit that one must stay away from while on Coumadin? I'm not really wanting much to eat right now, but fruit and some of the fruit shakes are sounding good.

    I know this is probably a dumb question, but I'm learning.
    Bi-Cuspid Aortic Valve - Diagnosed 2001
    St. Jude placed March 10, 2009
    Bentall Procedure March 10,2009
    Pacemaker placed March 16, 2009
    Dr. David Ott - Surgeon
    Dr. Michael Sortori - Cardiologist
    St. Luke's Hospital - Texas Medical Center

  • #2
    I've never had an issue with fruit, or any other foods for that matter. There are conflicting reports about cranberries and grapefruit. The key is to eat a diet that you enjoy and test regularly. Don't binge on anything, unless you plan to do it everyday.

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    • #3
      Cranberries have been cleared, but grapefruit juice may present a problem. I still drink it, but I wait at least 4 hours after taking my Coumadin before I do. I've had no problems. It can be a real big problem for some other meds, so if your on more then Coumadin, post them all.

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      • #4
        Grapefruit juice is not good to drink within a few hours of taking any medication from what I've read. It messes with the absorption or some such thing.

        Comment


        • #5
          lilteach:

          Fruit was one of the few foods I enjoyed immediately post-op -- particularly cantaloupe, pineapple and watermelon.
          I must have had thrush post-op (white-coated tongue -- yuck!), which kept me from tasting foods normally. I could taste sweet things very well, so I ate a lot of fruit.
          Breakfast was usually a bowl of cantaloupe & pineapple.
          Almost 6 years later, I still occasionally get a small bowl of cantaloupe & pineapple for breakfast -- and think of my post-op period when enjoying it!

          I have never noticed an interaction between fruit & warfarin. I like whole grapefruit, but John doesn't, so I don't buy it. Don't buy grapefruit juice. I love cranberry juice but seldom buy it.
          I believe our warfarin guru -- Al Lodwick -- has said that drinking cranberry juice is OK while taking warfarin, just don't drink it in lieu of all other fluids. ;) It's high in calories so I've bought the calorie-reduced versions.
          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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          • #6
            Pomegranite does act as an anti-coagulant. I drink the juice daily and it only effects me if I also eat the fruit. I have had to make a minor adjustment in my dose.

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            • #7
              Fruit?

              I drink fruit smoothies frequently following exercise and have never had any issues with adverse affects on my INR. I even eat energy bars that are high in Vitiman K while exercising without significant impact on my INR.

              Other's experinces with grapefruit juice probably differ from mine, but I've never noticed any adverse affect on my INR. I do take my coumadin late in the evening and on those occasions when I drink grapefruit juice it's a morning thing. The affect of the juice on how I absorb and metabolize my meds is probably moot due to timing circumstances.

              I still subscribe to the concept of dosing one's diet rather than attempting to manage INR with diet. This is simply my perspective and others may disagree.

              -Philip

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              • #8
                Fruit shakes: Banana, strawberry, mango, etc. are all great. Go for it.
                BAV-Aortic Stenosis...AVR Oct 11, 2005 / St.Jude Regent mechanical 21mm
                INR Home testing since 2007 with Coaguchek XS...Self-Dosing

                "Caution: I may have been in contact with Nuts"

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                • #9
                  Thanks everyone. I am learning and have been so happy because I have had no issues with my levels.

                  Tonight we went to Luby's cafeteria and I had a small bowl of fruit salad....chopped apples, grapes, bananas, and peaches....it was so good and wonderful for the taste buds....even hubby enjoyed a bowl.
                  Bi-Cuspid Aortic Valve - Diagnosed 2001
                  St. Jude placed March 10, 2009
                  Bentall Procedure March 10,2009
                  Pacemaker placed March 16, 2009
                  Dr. David Ott - Surgeon
                  Dr. Michael Sortori - Cardiologist
                  St. Luke's Hospital - Texas Medical Center

                  Comment


                  • #10
                    Originally posted by lilteach3234 View Post
                    Thanks everyone. I am learning and have been so happy because I have had no issues with my levels.

                    Tonight we went to Luby's cafeteria and I had a small bowl of fruit salad....chopped apples, grapes, bananas, and peaches....it was so good and wonderful for the taste buds....even hubby enjoyed a bowl.
                    The longer your on this drug, the more comfortable you become and soon, you'll spot BS stories and myths 10 miles out and start laughing uncontrollably at how stupid they are.

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                    • #11
                      I have a warning not to eat grapefruit on my Lipitor bottle
                      Congenital, bicuspid Aortic valve,Replaced Feb, 2004 with CarboMedics Mechanical valve
                      By Dr Salasidis at St Marys General in Kitchener, Ontario Canada

                      Comment


                      • #12
                        Originally posted by Old clicker View Post
                        I have a warning not to eat grapefruit on my Lipitor bottle
                        Ditto on my warfarin bottles. But that's okay, I don't like the stuff anyways Talk about pucker power eeeish.
                        Laughter is the Best Medicine
                        MVR March 30/07 Carbomedics Valve - Said and done in 5 days in Canada

                        Comment


                        • #13
                          Originally posted by lilteach3234 View Post
                          Thanks everyone. I am learning and have been so happy because I have had no issues with my levels.

                          Tonight we went to Luby's cafeteria and I had a small bowl of fruit salad....chopped apples, grapes, bananas, and peaches....it was so good and wonderful for the taste buds....even hubby enjoyed a bowl.
                          Which Luby's in the Houston area?
                          My cousin lives in Spring. When I've been down there, we've eaten at one off I-45 a little south of 1960.
                          I love Luby's veggie soup. John swears Luby's cornbread is the best he's ever had.
                          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


                          • #14
                            The labels on my prescriptions have no cranberries on my warfarin and no grapefruit on my simvastatin.

                            I just looked at the leaflet which is in with my warfarin and it does say that as there in no way of knowing exactly how much was ok, or which brands then it was best to avoid drinking cranberry juices and anyone drinking it for other reasons should speak with their warfarin clinic before stopping or reducing the intake of cranberry juice.
                            Lithotripsy for kidney stones 8 December 2004.
                            Began to feel unwell 19 December 2004, with hindsight, the beginning of endocarditis.
                            Stroke 12 March 2005.
                            Endocarditis diagnosed 16 March 2005.
                            MVR/AVR - ATS 30 June 2005.
                            Discharged 10 July 2005, taken ill on journey from hospital.
                            Admitted to hospital 14 July 2005, complete heart block.
                            Discharged from hospital 22 July 2005.
                            Returned to work 9am on 7 November, dismissed 9am 7 November 2005.

                            Comment


                            • #15
                              Again, cranberries have been cleared. Perhaps this post will put that case to bed:

                              Additional evidence has been presented showing the safe use of cranberry products for patients on Coumadin
                              An article appearing in the Journal of Health-System Pharmacist again evaluated the use of cranberry products and concluded the following:

                              Reports from the United Kingdom have raised concern over the interaction potential between cranberry juice and warfarin. Warfarin is the most commonly prescribed oral medication for anticoagulation therapy. Cranberry juice is a flavonoid, which has been shown to induce, inhibit, or act as a substrate for the biosynthesis of several cytochrome P-450 (CYP) isoenzymes. Specifically, cranberry juice may inhibit the activity of CYP2C9, the primary isoenzyme involved in the metabolism of S-warfarin. A search of the medical literature identified three peer-reviewed case reports and two peer-reviewed, prospective, randomized, placebo-controlled clinical trials using metabolic surrogates of warfarin (flurbiprofen and cyclosporine) that described possible interactions between cranberry juice and warfarin. Two case reports suggested that cranberry juice increased the International Normalized Ratio (INR) of patients taking warfarin, but neither clearly identified cranberry juice as the sole cause of INR elevation. One case report appeared to show a correlation between the effects of cranberry juice and warfarin metabolism. Both clinical trials indicated the lack of an interaction between cranberry juice and CYP isoenzymes 2C9 and 3A, both of which are necessary in warfarin metabolism. More studies are required to determine the potential interaction between cranberry juice and warfarin (Coumadin ).

                              The available data do not seem to show a clinically relevant interaction between cranberry juice and warfarin; however, patients taking warfarin with cranberry juice should be cautioned about the potential interaction and monitored closely for INR changes and signs and symptoms of bleeding.
                              American Journal of Health-System Pharmacy, Vol. 64, Issue 5, 490-494

                              Researchers at Tufts University researched cranberry extensively last year and gave cranberry the all clear to be used with patients taking warfarin.

                              The 2007 Anticoagulation Forum’s national meeting focused an educational seminar on dietary interactive products - including cranberries. Ann Wittkowsky, Clinical Professor [University of Washington School of Pharmacy, Seattle, Washington] led the discussion clearing the safe use of cranberry products, under normal consumption. Dr. Wittkowsky referenced a well designed, double cross-over study (Journal American Dietary Association 2006: 106-2057-61). The study conclusion re-affirmed no interactions were detected and cranberry products do not need to be avoided provided consumption was routine.

                              Another article: http://warfarinfo.com/cranberry.htm

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