Archive for the ‘warfarin / coumadin’ Category
Warfarin can, in rare instances, cause violaceous painful discoloration of the toes and the sides of the feet, referred to as the “purple toe syndrome” 1 – see photograph below. Occasionally, the hands can also be involved and a net-like skin rash on abdomen and legs (= livedo reticularis) can occur. This typically happens within the first few weeks of starting warfarin. Read the rest of this entry »
How common is it?
Hair loss is a known side effect of warfarin (Coumadin®, Jantoven®), but has hardly been studied [ref 1]. Solid data on how frequently it occurs, on its time-course, and on treatments are not available. Mild hair loss appears to be common, severe hair loss uncommon, complete hair loss has not been reported. Read the rest of this entry »
Certain pain medications increase the risk of bleeding in patients on warfarin (coumadin®, Jantoven). Two mechanism can be at play: (1) non-steroidal pain medications (NSAIDs = non-steroidal anti-inflammatory drugs) may lead to gastritis which can lead to bleeding into the stomach, made worse by being on “blood thinners”, and (2) pain medications taken on a regular basis may interfere with warfarin, leading to an increase in INR, increasing the risk for bleeding.
The table below lists oral pain medications that do not increase the risk for bleeding Read the rest of this entry »
Stephan Moll, MD writes…
Quite a few patients on warfarin have unstable, i.e. significantly fluctuating, INRs, making warfarin therapy cumbersome. The cause of such fluctuations is often not clear. However, the following causes should be considered. Solutions how to deal with fluctuating INRs are also listed below. Read the rest of this entry »
Background and Summary
Patients on warfarin can test their own INR (International Normalized Ratio) at home with small, handheld INR monitors, similar to diabetics checking their own blood sugar. A very large, well conducted study published on Oct 21, 2010 in the New England Journal of Medicine (ref 1) shows that patients can safely and effectively monitor their warfarin therapy themselves with INR home monitors. While this does not come as a surprise to many, this is the first very large and well designed trial to show this. Read the rest of this entry »