anti-inflammatory drug w/coumadin

[csutherland]

Al is probably the person who can help us with this one: Jerry is having severe plantar faciaitis (foot & heel pain) to the extent that he can hardly do his prescribed walking. He has had it before so we know what it is even though we haven't seen a doctor yet this time. He did ask the cardio's nurse by phone if there was an anti-inflammatory that could be taken and she said "no"--he'd have to take tylenol. That won't touch it. Our past experience has been that larger doses of ibuprofen gets rid it or at least keeps it at bay.

Do you think the nurse is correct? If so, isn't this a major drawback to the mechanical valve that requires a lifetime of coumadin. There could be many instances where anti-inflammatory drugs would be needed seems to me.

 

[Nancy]

Hi Celia-

I know you're waiting for Al's answer, but in 25 years on Coumadin, Joe has never been able to take anything but Tylenol. He did take Vioxx once, but it interfered badly with his Lasix and also the Coumadin, so that was out.

It might be possible for your husband's doctor to make adjustments in his Coumadin to accommodate Vioxx, if he's not on a diuretic. But Al would be the one to answer questions about Celebrex and Vioxx.

 

[ALCapshaw]

My cardiologist put me on Vioxx when I was having problems with my chest wall (rear side...I think someone tried to 'run me through' with the chest tube, but that's another LONG story).

Long story short: The Vioxx helped restore my breathing to normal after a few days. On day 5 and 6, I began to feel very weak and my legs felt quite heavy. I was advised to discontinue the Vioxx. My
INR went up to 3.8 while I was on the Vioxx.

Bottom Line: I was able to tolerate it long enough to alleviate my original problem. It would be wise to monitor INR closely while on any new mediation (say every 4 days).

'AL'
















;

 

[GregB]

Anti Inflammatory

Anti Inflammatory

I also had foot trouble.
Not really sure of the cause but it interfered with my exercise program for days at a time.
Also I found the constant aggravation had a negative effect on my morale and generally made me feel quite exhausted.

My Doc suggested I control the pain with paractemol. After a while he prescribed Anaprox 550(Naproxen Sodium) but suggested I take it only if desperate. Eventually I took 2 capsules and it cleared up for a while. The pain has returned a couple of times but I have been able to control it with Panadol/Paracetemol.
My understanding is that the Doctor was cautious about using anti-inflammatory because of risk of internal bleeding?? Not really sure though.
The drug seemed to have no effect on my INR reading and I managed to get away with taking the anti-inflamms. I was worried however as to what might happen.
In future I use them only as a very last resort.

Hope you are able to deal with the discomfort without resorting to additional drugs.

 

[ILoVeNY25]

Hi Celia,
Just thought I'd share my experience, 2 weeks after surgery they discovered I had pericarditis and I was put on Celebrex for almost 2 months. It didn't affect my INR at all, but I think the problem with it is that it shouldn't be for long term use. I would discuss it with your doctor. Hopefully it gets resolved someway. Take Care.

 

[csutherland]

Thanks for the tips. He'll be in contact with the cardio soon anyway. They're doing a 24-hr urine collection thing for protein/creatintine (sp?) levels because of ankle swelling w/pitting 2 weeks ago. I think they're seeing if CHF is going on or if it was a fluke. They put him on Lasix as soon as he told them about it by phone so there has been no more swelling.

Regarding the last post about pericarditis: Jerry had a pericardial window procedure in April. We don't know for sure that he had pericarditis, but blood had accumulated in the pericardium to the point that he had shortness of breath, swelling of abdomen & ankles, weakness, etc. That 2nd surgery was quite a setback but he feels great now, except for the foot pain. The cardio pretty much ignored his symptoms until it got really serious. We let him know that we want attention next time, so I think that's why he has ordered the urine collection for the tests.

 

[Lisa in Katy]

I took Vioxx without an affect on my INR, so different people react differently. Most other things that have reactions with Coumadin affect me, but not Vioxx. Of course my INR is 3.5-4.0 most of the time, so the person that mentioned his jumped to 3.8 was in a different situation. Vioxx might be the answer, but he would need to be monitored closely to make sure it doesn't affect the INR.

 

[csutherland]

Regarding INR, Jerry's was down to 1.7 Wed. It hasn't gotten over 2.37 since he was released from the hospital May 1 from the 2nd surgery. They increased the dosage to 7.5 daily instead of 5 mg M-W-F & 7.5 the other days. This kind of scares me. He is quite active and tries to stay away from too much Vit. K. He does like his cabbage-type veggies but we've cut way back. I can't imagine how he could have it even thinner when he bleeds so easily now. A tiny scrape makes a mess. Messes are better than strokes though and we hope the INR goes up next week. He has been on a 2 wk schedule for testing but they want him back in a week this time.

 

[Guest]

I'm sorry, I do not know how I missed this one for so long.

I have found Celebrex and Vioxx to be acceptable with warfarin. When the Vioxx interferred with the Lasix, that was most like the problem rather than the Vioxx interferring directly with warfarin. When people retain fluid, they do not metabolize warfarin as efficiently and the INR increases.

The blanket condemnation of anti-inflammatories shows a lack of knowledge about warfarin. There are no reports in any medical jorunal (that I can find after looking extensively) of anyone being harmed by naproxen and warfarin.

Between Celebrex, Vioxx, Bextra and naproxen there should be a product that will give relief without going to narcotics.