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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Little Toe Sprained And Have Bruising. Any Need To Decrease Warfarin Dose?

My husband is on warfarin. He sprained his little toe on Friday and of course, there is bruising. The bruising has extended beyond his little to those toward the great toe, which doesn't seem that unusual to me, since he popped it pretty hard on the couch leg, and then popped it again later. Should we decrease his warfarin for a day or two? We live overseas right now, and medical care is less than optimal, so any advice you can give is greatly appreciated. He is currently writing his cardiologist with the same question, but we wanted to get started on doing what we need to do, if we need to do anything other than the normal treatment--off the foot, ice, etc. He is planning to get an INR done tomorrow--the last one was 3.4 (he thinks) a month ago; he is now on 7.5 of warfarin 6 out of 7 days, and 5 the other day of the week, and has been for about a month, maybe 5 weeks.. Thank you.
Fri, 31 Jan 2014
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Internal Medicine Specialist 's  Response
Hi, to me he does not need any dose reduction. If he has any external bleeding that wont stop, then he has to stop the drug. Simple bruise is too small to risk the consequences of low INR. place cold packs to prevent further extension, and it is sufficient. You may also take the opinion of your cardiologist. Hope this helped.
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Little Toe Sprained And Have Bruising. Any Need To Decrease Warfarin Dose?

Hi, to me he does not need any dose reduction. If he has any external bleeding that wont stop, then he has to stop the drug. Simple bruise is too small to risk the consequences of low INR. place cold packs to prevent further extension, and it is sufficient. You may also take the opinion of your cardiologist. Hope this helped.