Anti-inflammatory drugs

[aussie girl]

I have read that anti-inflammatory drugs should not be used while on warfarin but was wondering if an anti-inflammatory cream such as Voltaren can be used. I checked past threads but they all referred to oral drugs.

Thanks Mary

 

[Ross]

Most all can be used, but some affect INR therefor, test about 3 or 4 days after starting it to see what's happening.

WARFARIN SODIUM (in Coumadin Tablets) may interact with DICLOFENAC (in Diclofenac Gel)

Blood clotting normally occurs in response to a cut or other types of injuries to protect the body from excessive bleeding. Platelets, a type of cell found in the blood, are involved in helping the blood to clot when it is needed. Diclofenac may interfere with the platelets' ability to work properly. It may also damage the lining of the stomach, particularly when used for a long period of time, and this may increase the risk of developing a bleeding ulcer. Warfarin is generally used to prevent your blood from "coagulating" or forming blood clots. When diclofenac and warfarin are used at the same time, your blood may be much less likely to clot and this may increase the risk of excessive bleeding. If it is necessary to use diclofenac while you are taking warfarin, your doctor may want to monitor you closely for signs of bleeding. Let your doctor know if your bowel movements appear black or tarry, or if you are having any stomach pain. Blood tests can be used to make sure that you are getting the right amount of warfarin. If you are experiencing problems, it may be necessary to adjust the dose of warfarin. Your doctor may also consider stopping therapy with diclofenac. Ask your healthcare provider about these drugs and this potential interaction as soon as possible.

This interaction is well-documented and is considered major in severity.

Last Updated: April 2008

 

[Duff Man]

I wouldn't take it if only because there's a risk of bleeding stomach ulcers which is obviously higher if you're on ACT. I've gotta be real hurt to take the stuff.

 

[aussie girl]

Thanks Ross and Aaron,

I can see how anti-inflammatory tablets could cause stomach ulcers but I'm at a loss to see how a cream used on a foot could do the same, isn't the cream only working on a localized site ???

Thanks Mary

 

[Duff Man]

Ohhhh... I read right over the cream part.

Um, as far as I can tell, there's a negligible amount of the stuff that's absorbed in to your bloodstream.

http://arthritis.about.com/b/2007/11/11/voltaren-gel-10-things-you-need-to-know.htm

The systemic absorption of Voltaren Gel (1 percent diclofenac sodium in topical gel formulation) is 94 percent less than oral diclofenac (generic for Voltaren).

http://www.medicalnewstoday.com/articles/87682.php

"Voltaren Gel delivers the proven efficacy of diclofenac with significantly less systemic absorption, minimizing the risk of side effects."

I was actually prescribed something really similar for a weight training injury. They were patches, but I was happy that I didn't have to take a pill that effects the entire body to get the medicine to my biceps. A minimal amount of the medicine goes to the body with the topical form... but for someone who's allergic or sensitive that might be enough to cause problems. Personally, I think the cream/patches/gels are the safest way you can do it.

 

[sue943]

That contains diclofenac and when I asked my pharmacist he told me not to use it.

 

[Duff Man]

That contains diclofenac and when I asked my pharmacist he told me not to use it.

did the pharmacist give you a reason?

 

[aussie girl]

Thanks everyone,

I've decided not to use the voltaren until I can speak with my doctor. Instead I'm using an ice pack which is giving some relief.

Thanks again Mary.

 

[sue943]

did the pharmacist give you a reason?

He just looked it up in his book and said that I shouldn't use it.

I know I used to use that drug in suppository form and my GP advised me to be very careful as the drug can cause stomach problems, and this was before I had any problems with my heart, in fact it was as I was incubating endocarditis.

 

[aussigal]

I have a feeling that if its only one or two applications for a short period of time it would be OK. I remember reading its long-term use of this stuff that gets us warafrin patients in trouble. I have some "percutane" cream that is a herbal version and completey safe for us. Ask at your local Chemist.

 

[lance]

Cortisone

Cortisone

Eczema is a chronic inflammation of the skin. I've been using topically applied cortisone for about 30 years and haven't noticed anything unusual warfarin wise.

I don't know how I'd fare in an Olympic drug test though. chuckle