A Lipitor/Warfarin Connection ?

[Computec]

My INR has been very stable since my MVR surgery a year and a half ago at 3.0.

My cholesterol count has always been on the high side at around 250 total although the preop angiogram showed perfectly clear coronary arteries. They were so clear that the cardio said that I'll never need to worry about cholesterol. In May, in order to appease my PCP, I agreed to go on Lipitor and my INR continued to be stable at 3.0 for a month. In August it jumped to 4.0 on the same dosage of warfarin.

Both my PCP and I were puzzled by this so we changed the dosage slightly to get it back to 3.0 but it dropped even lower than that on the changed dosage so I went back to the "normal dosage".

About 3 days before having the lab draw for the first INR reading I had a couple of 24 oz beers in the course of an evening. This is something I hadn't done for a long time. At first I thought the beer did it but researching the site here seems to indicate that this wasn't likely.

The "normal dosage" now takes me to 4.0 and the only thing I can figure is the Lipitor is having an effect. My research on the web says that the statin drugs work by binding to the albumin in the blood and taking them out of the bloodstream. This just so happens to be the same mechanism that removes warfarin from the bloodstream.

Has anyone gone on statins after having been on warfarin for a while and noticed this kind of change besides me? Maybe the 2 x 24 oz beers are the key but I need to dose the diet.

Thanks

Jerry

 

[Blanche]

Jerry:
Al was on anticoagulation for 11 years when he added Lipitor to his medications. He didn't notice any changes in his INR.

When you say "normal dose," do you mean the dose that you are used to taking? I would consider the "normal dose" the dose that one takes to keep one's INR in range. If you don't want your INR on the high side, decrease your dose a little bit. Sometimes Al has decreased his dose by .05 every other day. He does not care to be over 4.0.

Regards,
Blanche

 

[Karlynn]

I was on Lipitor for a long time and then went off it because I was getting bad hand and feet cramps (interesting when part of my living involves playing piano!). I noticed no change in my INR.

I wouldn't be too concerned about the "jump" to 4.0. Pulling a 3.0 one week and a 4.0 the next is what I consider "stable" for me. I'd make no changes until you have a 2nd test come back high. Just test in a week.

 

[hensylee]

I can't answer your question but wanted to suggest you listen to all your muscles while on Lipitor. Maybe you already know this?

 

[Computec]

Thank you all for your replies.

I'm NOT certain that the change in the INR is related but having seen the reference to the "possible" interaction as listed on WEBMD I started to wonder about it. Although it's not a common occurance it has been seen in some users.

As for watching for the dreaded side effects of statins... yes, I'm watching out for that as well. The nuances of pain caused by a new med and the "normal" pain of a 57 year old body can be subtle indeed.

Again, thank you.

Jerry

 

[aussigal]

I have noticed that since being on a statin and warfarin that I need about 5% less warfarin to stay in-range. Not really a big change but still a noticeable trend over the weeks was seen.

 

[Natanni]

My husband has no experience with Lipitor while on Coumadin. He did start Zetia (which acts more with the GI tract than with the liver) while on Coumadin with absolutely no change in his INR. His Zetia was discontinued 18months later, with a permanent drop in his INR 3 weeks later. He had to make his first dosage change after d/c the Zetia even though it didn't change his INR when starting the med. Go figure