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What Causes Elevated INR Levels While On Warfarin?
Question: Hi ! My Dad is on several medications.....Furosemide 40 mg 1/2 once daily, Atorvastatin 20 mg once daily, levothyroxin 100 mcg once daily, amlodipine besylate 2.5 mg daily, allopurinol 100 mg once daily. He goes to whorphrin (sp?) clinic and has been fine up until he had bronchitis and was put on z-pak. Now his numbers are screwed up....very high cumidon (?) #'s and he very low blood pressure readings. 100/50. He is 87 years old. No energy and not looking so hot! Now another doctor has him on nitro pills ( not doing, because he's never had any heart pain). He's going to Cumidon clinic Sunday and back to dr on Weds. Any suggestions!!!!
Brief Answer:
increased INR means increased risk of bleeding
Detailed Answer:
HI, thanks for using healthcare magic
Warfarin is an anticoagulant that is used to decrease the chance of clot formation in those persons at risk.
It is monitored by INR levels. An increase in INR means that the action of the warfarin is too much and there is a risk of bleeding, a decrease in INR means that the action is too little and there is a risk of a clot being formed.
Z pak (Azithromycin) can interact with warfarin and cause increased levels because it prevents its break down.
Increased levels of warfarin would cause an increase in INR and mean that there is increased risk of bleeding occurring.
The effect of the z pak should wear off within a few days to 1 week of finishing the medication. His warfarin levels would then return to normal.
When he goes to the clinic on Sunday and they do his INR, they would determine if the levels are good or if the warfarin needs to be decreased for a short time.
Summary: (1)INR monitors warfarin and the risk of bleeding or clotting
(2)high INR mean increased risk of bleeding
(3)z pak causes increase warfarin with increased risk of bleeding- increase INR
(4)effect should decrease within a week if stopping med
I hope this helps,feel free to ask any other questions
increased INR means increased risk of bleeding
Detailed Answer:
HI, thanks for using healthcare magic
Warfarin is an anticoagulant that is used to decrease the chance of clot formation in those persons at risk.
It is monitored by INR levels. An increase in INR means that the action of the warfarin is too much and there is a risk of bleeding, a decrease in INR means that the action is too little and there is a risk of a clot being formed.
Z pak (Azithromycin) can interact with warfarin and cause increased levels because it prevents its break down.
Increased levels of warfarin would cause an increase in INR and mean that there is increased risk of bleeding occurring.
The effect of the z pak should wear off within a few days to 1 week of finishing the medication. His warfarin levels would then return to normal.
When he goes to the clinic on Sunday and they do his INR, they would determine if the levels are good or if the warfarin needs to be decreased for a short time.
Summary: (1)INR monitors warfarin and the risk of bleeding or clotting
(2)high INR mean increased risk of bleeding
(3)z pak causes increase warfarin with increased risk of bleeding- increase INR
(4)effect should decrease within a week if stopping med
I hope this helps,feel free to ask any other questions
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
He has stopped the z-pak over 2 weeks ago and now is off warfarin and his level is still HIGH.
Brief Answer:
good, this means the levels would slowly normalize
Detailed Answer:
HI
The levels would come down, this is the reason the blood tests would be suggested every few days till the readings normalize.
In most cases, would suggest blood tests every 2 to 4 days till the INR is back in range.
If warfarin has been discontinued, this means that even with elevated INR, the risk of bleeding would be reduced because the medication is not continually being given at this point
When the INR goes back to normal, the warfarin would likely be restarted
good, this means the levels would slowly normalize
Detailed Answer:
HI
The levels would come down, this is the reason the blood tests would be suggested every few days till the readings normalize.
In most cases, would suggest blood tests every 2 to 4 days till the INR is back in range.
If warfarin has been discontinued, this means that even with elevated INR, the risk of bleeding would be reduced because the medication is not continually being given at this point
When the INR goes back to normal, the warfarin would likely be restarted
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
what about his blood pressure being so low 100/50
Brief Answer:
his doctor may consider temporary discontinuation of bp meds
Detailed Answer:
Hi
Hypotension is defined as blood pressures of less than 90/60 so the bottom value is below this limit.
There are some persons who have blood pressures around these values and have no symptoms because it is their normal but since your father is feeling the effect of the lower pressure, his doctor may advise temporary discontinuation of this bp meds for a very short time.
His bp would be monitored at home to note any changes.
This would have to be discussed with his doctor
If it is possible medically (eg no heart failure, kidney failure or liver failure), he can also increase his fluids and salt intake, this would increase the blood pressure.
his doctor may consider temporary discontinuation of bp meds
Detailed Answer:
Hi
Hypotension is defined as blood pressures of less than 90/60 so the bottom value is below this limit.
There are some persons who have blood pressures around these values and have no symptoms because it is their normal but since your father is feeling the effect of the lower pressure, his doctor may advise temporary discontinuation of this bp meds for a very short time.
His bp would be monitored at home to note any changes.
This would have to be discussed with his doctor
If it is possible medically (eg no heart failure, kidney failure or liver failure), he can also increase his fluids and salt intake, this would increase the blood pressure.
Note: Get a consultation booked to know more about aging related medical issues. Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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