Warfarin and Ibuprofen

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nickm3

Well-known member
Joined
Aug 8, 2007
Messages
52
Location
Near Phila. PA
I'm two weeks post AVR surgery and am taking warfarin. My pain has been manageable but I would really like to a motrin or two when the aches start to build up and prevent me from being able to get comforatble. When I asked they gave me Motrin in the hospital but now I get different answers/ opinions depending on whom I ask. Note that one dose always does the trick, have never had to take it consecutively, and Tylenol just doen't cut it.

Any clarification would be much appreaciated.

Thanks,Nick
 
My only knowledge of pain meds is that we can't take anti-inflamatories which i think ibuprofen is.

not sure where i've picked this nugget of info up from but i must have been told it strongly on at least one occasion....being over a year past surgery the strongest thing i take is paracetamol.
 
The reason antiinflammatories are usually avoided in anticoagulated patients is that many of the NSAIDs can cause stomach bleeding.

Aspirin, and to a lesser extent some of the other NSAIDs, will also have an anticoagulative effect. However, that effect works in a different way than warfarin (Coumadin), and it won't show up in your INR readings, so you can't monitor it.

In some people, stomach bleeding doesn't seem to happen, or it's insignificant. In others, it can lead to a troublesome or even dangerous internal bleed. All indications seem to be that for mild and occasional use, most people fit in somewhere in the first group. The problem is that you don't know which group you will fit into.

In discussions on this board, naproxen sodium (Aleve) has often been touted as a less dangerous NSAID option for stomach bleeding. You can look up previous threads on this topic, where Al Lodwick has weighed in.

Acetaminophen (Tylenol) is not an NSAID, and doesn't have these issues. I don't know enough about HEAD ON, so I can't comment on that one. It doesn't go through the stomach, but again, I have no information on its action. A quick look at websites selling it does not show any warnings about not using with anticoagulant prescriptions. Just about everything else in pain relievers over the counter is an NSAID.

In any event, be sure your doctor is aware of what you're taking in terms of NSAIDs, don't take more than directed or prescription strengths of them, monitor for dark stool (not foolproof, but at least something), and don't take them continuously or frequently.

Best wishes,
 
MY understanding is that anti-inflamatories are also anti-platelet drugs which help to prevent clots from sticking together.

They CAN cause / exacerbate bleeding and do NOT affect INR so there is no way to monitor their effect (to my knowledge). This is why they are used with extreme caution when taking Coumadin. Be sure that your surgeon, cardiologist, and Primary Care Doctor all know you are taking an anti-inflamatory if you are on Coumadin or Warfarin.

'AL Capshaw'
 
I take ibuprofen when I need it (which isn't daily) without issue. I think the key is the fact that you are 2 weeks post OHS. Have you tried Tylenol?
 
I have been told Not to take Naprosyn or ibuprofen. Mind you, if I put my back out or something similar, I would be wanting ibuprofen.
Tylenol worked fine for the first few days post op, but then I stopped that too.
 
Since I'm only two weeks post op I'm still getting my INR checked weekly. I did get an ok from my cardio's office to take ibuprofen on a limited basis and we will talk more about it when I go in for my first post op visit next tuesday (1/22). I've been home for week and have only taken it twice so I don't think I'm at too much risk.


Thanks everyone for the advice and warnings, once again VR.com comes thru when you need the straight scoop.

Nick
 
http://www.valvereplacement.com/forums/showthread.php?t=12537&highlight=naprosyn

http://www.valvereplacement.com/forums/showthread.php?t=10260&highlight=naprosyn

.

I get better pain relief from Naprosyn plus tylenol than I do from oxycodone, and no nausea. The naprosyn does make my gut rumble a bit, but I've never had any bleeding problems. No blood in my stool, no black stools, nothing like that. That's not to say it could never happen -- but for something short-term I'm reaching for the Naprosyn again if I ever need it.[/QUOTE]

Interesting. Just the opposite with me. Love Percoset (7.5 mg oxycodone plus tylenol)....... hate Naprosyn.
 
I have taken the occaisional ibuprofen for random headaches or the odd muscle strain etc with no ill effects., wouldnt do this on a regular basis though. Better to ask for another alternative, in Australia we often use Panadeine which is codeine and paracetamol...maybe you guys have something similar.
 

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