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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Blood Clot In The Vein In Lower Leg. Took Coumadin. Recurrent Infections After Hip Replacement. How Can I Stabilize The Coumadin Dose?

I have been on Coumadin for four weeks for a blood clot in a small vein in my lower leg. Also, on Clindamycin , same time period, for infection. Previously, I have suffered from many infecttions, in various parts of my body, since July 2012, when I had a hip replaced. I am a 52 year old female. Question: I have kept my vitamin K daily level at 19-22 mcgs. I still have to have my pt levels checked 2-3X/week. The Coumandin dose has not stabilized. What am I doing wrong? Lori Donohue
Thu, 14 Feb 2013
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Dear Thomas,

Thanks for your question.
Achieving a stabilized INR while on warfarin can be quite challenging sometimes. Several antibiotics (penicillins and cephalosporins) and even certain vegetables have been known to interfere with its metabolism and consequently its actions. I would suggest that you interact with your physician, with a view to re-evaluate all your medications (and possibly, meals), to determine which, if any, interact with warfarin.
Having said that, I would also mention that you keep to a fixed time of warfarin intake, preferably well after the last meal of the day (i.e. just before bed). Avoid, as much as possible, any food or medication that may interfere with it. All PT tests should be done in certified labs, and all values converted to INR. I hope these measures will help.

Kind regards.
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Blood Clot In The Vein In Lower Leg. Took Coumadin. Recurrent Infections After Hip Replacement. How Can I Stabilize The Coumadin Dose?

Dear Thomas, Thanks for your question. Achieving a stabilized INR while on warfarin can be quite challenging sometimes. Several antibiotics (penicillins and cephalosporins) and even certain vegetables have been known to interfere with its metabolism and consequently its actions. I would suggest that you interact with your physician, with a view to re-evaluate all your medications (and possibly, meals), to determine which, if any, interact with warfarin. Having said that, I would also mention that you keep to a fixed time of warfarin intake, preferably well after the last meal of the day (i.e. just before bed). Avoid, as much as possible, any food or medication that may interfere with it. All PT tests should be done in certified labs, and all values converted to INR. I hope these measures will help. Kind regards.