Is there a web site I can go to to find what risk factor really is? I am stopping coumidin so I can take anti inflammatories.
Do not stop it without your drs approval. A stroke or heart attack could happen that way. Try to work out something with him. If he's saying you're high risk, you are in danger of those things happening without it. There is no place to figure out your risk. You have to learn to trust your dr, and give up some control of your medication. If you don't trust your dr, find a new one.
NSAIDs and aspirin should be avoided if possible in patients taking anticoagulants.
If it is necessary to combine NSAID and warfarin, an increase in INR should be expected. This means your blood takes longer to clot and is more difficult to stop bleeding.
Talk to your doctor again. Ultimately it's your choice.
You may be able to take both but would need careful INR monitoring, warfarin dose adjustments, and preventative medicine to protect your stomach from bleeding.
Use of Coumadin and an NSAID is not recommended. The relative risk of bleeding complications is increased over 5 times and there is a major increase in the risk of developing hemorrhagic peptic ulcer disease if you are a senior.
Ask your doctor about switching to Arixtra or Lovenox to bridge you before and after the ablations. This way you will be covered for your DVT & PE and you can discontinue 24-72 hours vs up to 7 days before your procedure and restart 24-48 hours after. You still will have issues once you start the anti inflammatories. If you are given Celebrex, instead of a standard NSAID, with Arixtra or Lovenox you should probably take a medication to protect your stomach. Be aware of increased GI bleeding.
Theoretically, NSAIDs may potentiate the risk of bleeding complications associated with the use of Arixtra or Lovenox. NSAIDs interfere with platelet adhesion and aggregation and may prolong bleeding time in healthy individuals. If you are given a standard NSAID, ie ketorolac or an opioid plus acetaminophen, then your dosage of Arixtra or Lovenox should be fine, or possibly reduced as a protective measure, as long as you are not given NSAIDs chronically or in high dosages. Be aware of increased GI bleeding.
Your last option is to switch to Xarelto. If you do this you may need a reduced dose of Xarelto or more frequent monitoring by your doctor to safely use both medications, since combining these medications can increase the risk of serious or life-threatening bleeding complications.
As an aside, your issue with being cold especially during the winter will probably go away once you switch over to Arixtra, Lovenox, or Xarelto. Any of these drugs can be used for the rest of your life like Coumadin. I would use the Arixtra over the Lovenox if you don't choose the Xarelto.
Your doctors can discuss more about this when they come up with an overall plan for your procedure. Hope this helps.
- Coumadin Information for Consumers
- Coumadin Information for Healthcare Professionals (includes dosage details)
- Side Effects of Coumadin (detailed)
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