Anti Inflammatory Options While On Warfarin?

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Thomas

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I've slipped a disk in my back and I'm in need of drugs both for inflammation.
Is there an option for an anti inflammatory that I could take while permanently taking warfarin.
I've read a lot and don't see any options.
thanks
 

dick0236

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I've slipped a disk in my back and I'm in need of drugs both for inflammation.
Is there an option for an anti inflammatory that I could take while permanently taking warfarin.
I've read a lot and don't see any options.
thanks
I've only taken generic Tylenol. Fortunately, I've never had to deal with severe pain......but I do take a couple "Tylenol" for back pain daily for the aches and pains of old age:(. When my back pain gets real bad I go to a physical therapist.
 

catwoman

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If you have a chronic pain, you should see both your family doctor (or specialist for that part of the body) and your cardiologist; they may want to confer with each other.

My PCP and cardio have OK'd me taking Aleve for short periods, no more than a few days, usually only taking two tabs once daily. I don't have GERD, so no risk of GI bleed. I have not noticed any effect on my INR, but I don't take the NSAID for more than 2-3 days at the most.
 

Thomas

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Thanks for the replies folks.
I was at the pharmacy yesterday and the pharmacist recommended a topical cream "Volataren" He said it's basically an anti inflammatory but because it's topical and not taken internally, there is no risk of it affecting INR.
Anyone had experience with it or have an opinion on that statement?
thanks
 

Protimenow

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I recently saw a research paper (and I can't remember the source) that indicated that topical anti-inflammatories (like Aspercreme) do, indeed, cross through the skin. In extreme cases, these have been reported to increase INR.
If you have a meter, you probably should test your INR every few days while you're using the cream, just to be sure that there's no effect.

If you end up using this long-term, you may consider adjusting the dose of warfarin. It would make sense to find a doctor who knows about anticoagulation and check with her.
 

Thomas

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I'm using it sparingly; once in the morning once at night. Seems to relax things a bit.
I've been using it for a couple of days now and I'm testing today. I don't think based on the amount prescribed in the package that it will affect my INR but we'll know later.

I won't need it very long. This has been a chronic issue I've delt with since I was running marathons back when I was young and spry. So I'm pretty used to the cycle of recuperation. This is just the first incident since being on warfarin so I wasn't sure.

thanks
 

Protimenow

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The effects of aspirin (or topical creams containing aspirin-like substances) may not show up on a blood test. Aspirin makes the platelets 'less sticky' than they'd otherwise be. The effect on clotting is different from what warfarin does.

If you don't use the cream much, you should be okay -- but, again, the effect of the cream may not show up on your INR - but the cream or aspirin COULD still extend clotting time.
 

Thomas

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Protimenow, that's interesting. I'm not using much of it but how would I know then if the cream is having an affect ... short of hitting my my head and waiting to see what happens? I'm not overly technical with this type of thing but that doesn't seem like a very scientific way to go about finding out. : )

My INR read at 3.2 today. It was 3.0 last week so using the ignorance is bliss theory, everything should be fine. A minor variation and still within range.
 

tom in MO

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You should ask your cardiologist. I am on warfarin and my cardiologist (2 of them) allows me to take over the counter NSAIDs (e.g. Allieve, ipubrofen) up to the maximum over the counter dose for no more than 2 months. Also vicadins help too :)
 

Protimenow

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I broke my wrist a few years ago. The doctor who treated me kept trying to push Norco on me. (Norco is acetaminophen(tylenol) with codeine). I always refused it.
I told him that I took Ibuprofen and he didn't like that idea - he told me that even though an NSAID didn't show up in the blood tests, it made the platelets less sticky and could accelerate bleeding.
Tom - if your cardiologist said you can take NSAIDS for two months, this sounds interesting. As for me, I avoid NSAIDS (except for my 81 mg aspirin) unless I'm REALLY hurting.
I have Norco that was prescribed by doctors when I was in the hospital in November - and I'm trying to figure out how to safely (and legally) dispose of them.
 

Thomas

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I have a call into my cardio on it. Except for 81mg Aspirin, I've avoided advil and others in the family completely. It would be a nice short term option as Tom said. My honey do list is getting longer and longer.
 

tom in MO

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I was told by my orthopedist that I needed NSAIDs due to arthritic "episodes". The orthopedist told me to check with my cardiologist to see if I could take them and for how long and how much. He said some people can and some can't, but he doesn't make that decision, the doctor who is managing your INR does.

More than one doctor has told me NSAIDs can lead to stomach bleeding which is hard to treat if you are on warfarin. That's why I can take an NSAID, but only at the over the counter dose, not the higher prescription dosages, and only for 2 months.

I was told to take the minimum amount for a therapeutic effect, some times you don't need 2 pills three times a day. I have pushed the time period to 3 months once. There used to be someone else on here who was allowed to take an ipubrofen every night before bed since she had back problems.
 

Thomas

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I just got off the phone with the cardio. He said it would be ok to take non prescription ones like Advil but to be very sparing with them. He mentioned the stomach bleeding possibilities as well. He's not heard of any issues with topical creams. Who knows how much he's up on all of the info available though.
Think I'll just stay with the cream for a couple more days.
 

Gustav

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Thanks for the replies folks.
I was at the pharmacy yesterday and the pharmacist recommended a topical cream "Volataren" He said it's basically an anti inflammatory but because it's topical and not taken internally, there is no risk of it affecting INR.
Anyone had experience with it or have an opinion on that statement?
thanks
Voltaren cream/gel is one of the few things that shot my INR up only realising on the 3rd day of usage. Something that works with me is Solpadeine taken when I sprained my foot badly apart from that I only rely on paracetamol.
 

Thomas

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I've been applying the Voltaren for 5 days now and I'm thinking it's the last day today. When I tested after 2 1/2 days there was negligible INR change; 3.0 to 3.2. I'll do another test on Friday and see where things are at just to make sure.
Solpadeine is sold as Atasol in Canada. I'll have a look into it. Thanks!
 

carolinemc

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I've been applying the Voltaren for 5 days now and I'm thinking it's the last day today. When I tested after 2 1/2 days there was negligible INR change; 3.0 to 3.2. I'll do another test on Friday and see where things are at just to make sure.
Solpadeine is sold as Atasol in Canada. I'll have a look into it. Thanks!
Please take the sound advice, always talk to your cardio, not the pharmacist when taking anything over the counter, creams, anti-inflamatories, antibotics, etc, for they affect the INR numbers. Never take a chance, talk to the cardio. Hugs for today.
 

W. Carter

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I have resided to going without any arthritis meds or over the counter pain meds. Even Tylenol shoots my INR up. If I get a cold I just do what my INR clinic advised. Tough it out. Some say they take Tylenol with no problems but from what i've learned the hard way Warfarin effects everyone differently.
 

Warrick

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From what I have seen myself topical and oral doses of the same medication can have different effects and in some cases which I wouldn’t have expected as its only going on your skin topical medications have a much greater effect. So if one version doesnt have an effect dont just expect the other not too.

Dr google might get some flak but Iv found you can generally find if there will be an interaction with meds and even when the doctor prescribes it because he is unaware of interactions google can save your bacon.
 
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Protimenow

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FWIW - I'm going through a situation where my elbow is inflamed, and the rheumatologist extracted about 8 ml of blood from the swelled area. He suggested that I take an anti-inflammatory. I told him that I take warfarin and NSAIDs are probably not an option.

He told me that the safest NSAID (it has the least impact on platelets) is Celebrex. He ordered a prescription for a few days of Celebrex. Unfortunately, insurance formularies don't cover this under insurance (it's too similar to many OTC NSAIDs), and I didn't want to (and couldn't) pay almost $34 for just a few pills. I was also worried that, if I had blood in my elbow, NSAIDs may make the situation somewhat worse.

The point here -- Celebrex may be an option for inflammation -- if you can afford it.
 

carolinemc

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@Protimenow, You need to talk to your cardio on what they suggest, since this affects the INR. I take tylenol extra strength, since I do not use it very much. Good luck in talking to a cardio, best person to guide you on this. Hugs for today.
 
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