![[Coumadin Logo]](http://www.oralchelation.com/images/coumlogo.gif)
Click here to return to the FAQ about Coumadin
Welcome to ....
 |
Questions in The Heart Forum are being answered by doctors from The Cleveland Clinic Heart Center, consistently ranked the #1 Heart Center in America.
Subject:
coumadin and alcohol
Topic Area: Heart Disease
Forum: The Heart
Forum
Question Posted By: Cathy on
Friday, August 28, 1998
My husband has Marfan's syndrome, and had his aortic valve and arch
replaced (both are artificial/mechanical) about five years ago due to
an aortic disection. He is 23 years old now. He was put on coumadin,
3 mg per day, and also atenelol 100 mg per day. He recovered well and
hasn't had any problems since.My question has to do with alcohol consumption. Is it bad for someone
with Marfan's to drink? Or for someone taking his medications? He has
a drink now and then, not a lot, but when I've asked him about it he says
it's fine as long he doesn't get hurt (since the blood would clot more
slowly on coumadin, and even more slowly with alcohol in the system). Am I
being paranoid here? I want him to enjoy himself, and truthfully nothing
bad has ever resulted from him having a drink now and then. He says his
doctor OK'd it as long it was moderate, but I still worry. Also, if
alcohol increases the effect of coumadin, how much does it increase it by,
and for how long? Is it really OK as long he's just careful not to injure
himself? And how much alcohol is "moderate"? This has been bothering me
for a while now, so any input would be appreciated._______________________________________________________________
Dear Cathy, thank you for your question. Alcohol can interact with coumadin through it's metabolism in the liver. Alcohol is degraded by enzymes in the liver. Clotting factors are also made in the liver so coumadin exerts its effect in the liver. Certain clotting factors depend on vitamin K to be produced. Coumadin inhibits vitamin K to cause the blood the be "thinned." When execesive alcohol is consumed, the liver is "preoccupied" with degrading the alcohol and may actually be damaged by the alcohol. When this occurs, the effect of vitamin K is magnified so the blood can be over anticoagulated. It's difficult to say how long this effect lasts since the metabolism of alcohol and coumadin is highly variable in different patients. Also, since alcohol can impair the senses and put patients at a higher risk of falling or having an accident, the risk of bleeding while on coumadin and alcoholo can be increased. Typically, I advise patients taking coumadin to have no more than one drink per day (12 oz. beer, 4 oz. wine, 1 ox. hard liquor) which would be considered "moderate" and should not cause any problems. Certainly, more than 2-3 drinks/day would be considered excessive when someone is taking coumadin. I think your husband should do fine with moderate alcohol consumption but only his physician can determine what is "moderate" consumption in his case. Alcohol consumption does not affect the disease process of Marfan's syndrome I hope you find this information useful.
Information provided in the heart forum is for general purposes only. Specific diagnoses and therapies can only be provided by your physician.
BLOOD THINNING OR ANTICOAGULANTS - COUMADIN
There are a number of blood thinning agents that are available in medicine. The drugs used over the years have included Coumadin, Heparin, Low molecular weight heparin or Lovenox, aspirin, Plavix, Ticlid, Persantine and Anturane.
What It Does
Coumadin (warfarin) is a drug that is taken by mouth. It acts on various components of the blood clotting mechanism to prevent blood clotting in the body. A cascade of known blood factors act in sequence to cause the blood to form a blood clot. This activity is partly disrupted by the use of Coumadin.
What Test Is Required and Frequency to Control the Use of Coumadin
A blood test called the Prothrombin time is used to control the amount of Coumadin that an individual takes. It is standardized by an international unit called the INR, which has worldwide application. It is suggested by most cardiologists that a blood test for the Coumadin dosage be obtained at least every three weeks. Coumadin should be used at the end of the day so that one's blood test can be evaluated early in the day and the amount of Coumadin medicine prescribed changed if necessary by reviewing the blood test ie. the INR.
Health Conditions Requiring Coumadin
There are a number of cardiac and other health conditions which prompt and advise the use of the anticoagulant, Coumadin. Those patients with most prosthetic (artificial) valves of the heart require Coumadin. The rhythm abnormality called atrial fibrillation, or an irregular heartbeat requires Coumadin. Big hearts or dilated hearts (cardiomyopathy) frequently require Coumadin. Pulmonary embolism or blood clots in the lung and thrombophlebitis or blood clots in the legs require anticoagulation with Coumadin. The distinct entity of pulmonary hypertension or high blood pressure in the lung artery frequently requires anticoagulation with Coumadin. Other specific blood clotting disease (coagulopathies) also may require the use of anticoagulation with Coumadin.
Over Medication With Coumadin
Over medication with Coumadin can cause severe bleeding and death. Bleeding may occur inside the head, inside the heart, inside the kidneys, the bowel or the lung. It commonly is seen as severe bruising in the skin. Adjustment of the Coumadin dosage would be essential.
Inadequate Anticoagulation of Blood Thinning
These result is serious consequences as well with patients having cerebral vascular accidents (strokes), heart attacks or blood clots going to any organ or to any extremity.
When to Take Your Coumadin
It is recommended that you take your Coumadin at the same time each day, usually before or after the evening meal. On the day of your Protime this allow your physician to reach you before you have taken your medication in case any adjustments are necessary.
SAFETY TIPS
Guard against cuts; wear shoes. When gardening or doing similar work wear gloves. The use of an electric shaver is advised.
Avoid food fads, crash diets or marked changes in eating habits. Certain foods are high in Vitamin K. These need not be avoided; however, a marked change in the amount of these will alter your response to Coumadin. These are alfalfa, cabbage, cauliflower, liver, spinach, soybeans, fish and fish oils.
Alcohol enhances the effect of Coumadin. If you drink, ask your physician about guidelines for amounts that are safe.
Don't play contact sports that can subject you to injury.
Have regular dental checks to assure oral hygiene and avoid disease. Remember to inform your dentist that you take Coumadin.
Women should notify their doctors as soon as they suspect they are pregnant.
Many factors can influence Coumadin response and Protime levels. These include diarrhea, decreased liver or kidney function, emotional upsets, harsh laxatives, vitamins, infections, weather changes, antibiotics, aspirin and other drugs.
You should wear or carry identification indicating that you are taking Coumadin. Cards are available and most pharmacies carry bracelets or necklaces with this information.
CALL YOUR DOCTOR IF:
FACTORS THAT INCREASE YOUR PROTIME ( MAKE YOUR BLOOD TOO THIN)
Internal Factors
|
External Factors
|
MEDICATIONS
| Allopurinol ( Zyloprim) | steroids |
| antibiotics | Chloral Hydrate |
| Diabenese (chlorpropamide) | Tagamet (cimetidine) |
| Atromid-S (clofibrate) | Dextran ) |
| Hyperstat (diazoxide | Antabuse (disulfiram) |
| Edecrin (ethacrynic acid) | Nalfon (fenoprofen) |
| Glucogon | Ibuprofen (Motrin, Advil, Nuprin) |
| Indocin (idomethacin) | Aldomet (methyldopa) |
| Ritalin (methylphenidtae) | Flagyl (metronidazole) |
| Nardil (MAO inhibitors) | Anaprox (naproxen) |
| Pamelor (nortriptyline) | Butazolidine (phenylbutazone) |
| Dilantin (phenytoin) | Quineglute (quinidine) |
| Quinine | salicylates (aspirin, Bufferin) |
| Anacin | Darvon Compound |
| Anturane (sulfinpyrazone) | Bactrim (sulfa drugs) |
| Clinoril (sulindac) | Synthroid (thyroid drugs) |
| levothyroxin | Orinase (tolbutamid) |
FACTORS THAT DECREASE PROTIME ( MAKE YOUR BLOOD TOO THICK)
Internal Factors
|
External Factors
|
MEDICATIONS
| adrenocortical steroids Actifed Benadryl (diphenhydramine) Nyquil Triaminic Seconal Chloral hydrate Questran (cholestryramine) Placidyl (ethchlorvynol) Haldol (haloperidol) oral contraceptives Dilantin( phenytoid) Vitamin C |
antacids (Riopan, Mylanta, etc) Atarax Dimetapp Phenergan Anytal Nembutal Librium (chlordiazepocxide) estrogens Doriden (glutethimide) Miltown (meprobamate) paraldehyde Rifadin (rifampin) Vitamin K |
MEDICATIONS CONTAINING SALICYLATES
| Alka Seltzer APC Ascriptin Aspirin, Children's Bufferin Cope Coricidin-D Darvon Compound Ecotrin Equagesic Excedrin PM 4 Way Cold Tablets Midol Norgesic Pabirin Palgesic Percodan Phenergan compound St. Joseph aspirin Synalog Soltice cold tablets Triaminicin |
Anacin Aspirin Aspergum Bayer Congesprin Coricidin Darvon Dristan Empirin Excedrin Fiorinal Liquiprin Nuprin Novahistine PAC compound PC-65 Phenaphen Pyrroxate Supac Sine-Aid Quiet World Vanquish |
These medications contain aspirin (salicylates) and should not be used if you are using Coumadin. This is only a partial list, many medications contain aspirin and you should check the labels of all medications very carefully. Tylenol, Datril or other brands of Acetaminophen should be usedfor minor aches or pains.
The importance of blood thinning or anticoagulation with Coumadin is very important for patient health. Adjustments of the Coumadin dosage should be made at least every three weeks by testing the blood Prothrombin time and the INR. Medications are prescribed by other physicians should be discussed with the physician or cardiologist who is caring for the Coumadin dosage. Failure to do so may result in catastrophic experiences.
The statements provided in this report are for information only. This is not intended to be medical advice. Each individual may react differently depending on a variety of circumstances. It is therefore imperative you consult your physician prior to following any of the contents of this report. CardioDoc.net and CardioDoc.org disclaim any and all liability.
|
I promise to answer your message -- click here to send me a personal message
|
SUBSCRIBE: The Wednesday Letter is a free electronic monthly newsletter written and published by Karl Loren. You can view more than 50 back issues of this publication by clicking here. The Wednesday Letter subscription list is maintained on a secure server, no name is ever given or sold to anyone, and it is never used except for this Newsletter. It is automatically published on the Tuesday night just before the first Wednesday of every month. You can subscribe to this free monthly electronic letter by entering your eMail address and name below. You will then automatically receive a request for confirmation, sent to whatever address you have entered. If you do NOT receive this confirmation request, then you will not be subscribed. There may have been an error with your address and you should resubmit. The letter is never sent twice to the same address -- so you do not have to worry about a duplicate subscription. When you receive this confirmation request you must reply to it, or your subscription will not become active. No one can subscribe your name, and address, without you being notified, and if you get an unwanted notice of subscription you only need to DO NOTHING and the subscription will NOT be active.
REMOVAL: You can remove yourself from the subscription list in several different ways. Click here to read about this entire newsletter system. Every edition of The Wednesday Letter is delivered to your address with YOUR name and address in view on the letter, with a link that allows you to remove THAT name from the subscription list. If you try to send this removal message from an address different from the one you used to send in your original confirmation, then you will get a warning notice first, sent to the subscription address, asking you to confirm that you want to be removed from the list -- by replying to THAT request for confirmation, you will then be automatically removed. Thus, no one else can unsubscribe you, from some other computer, without your knowledge. But, if you send in the unsubscribe notice from the same machine used to receive the Letter, then the removal from the subscription list is automatic.
Personal Message: When you send a personal message to Karl Loren, you will receive a personal reply as per his instructions. Karl pledges that every personal message will get a personal answer. When you provide your mail address, we will send you free information including our free catalog and a cassette tape lecture by Karl Loren about heart disease, no charge, by mail, even if outside the US. You can select particular information you would like to receive, along with the free cassette tape and catalog.
You can reach Vibrant Life in many ways, including by mail to Vibrant Life, 2808 N. Naomi St., Burbank, CA 91504. Within the US and Canada, use the toll free number: (800) 523-4521, the local number: (818) 558-1799, the FAX: (818) 558-7299, eMail to kimberly@oralchelation.com or any one of the hundreds of message forms throughout the 50 web sites. Vibrant Life normally ships the same day we get an order. There are message forms on each of the 100,000+ pages on this and other sites where you can communicate with Vibrant Life. Check out our companion site, at: http://www.oralchelation.net where Karl's 2000 page book is published. Karl Loren is the author and webmaster for this BOOK, as well as for another web site about ORAL CHELATION. His personal philosophical articles are at PHILOSOPHY.
Copyright © May 20, 2008 6:23 AM by Karl Loren on behalf of Vibrant Life, ALL RIGHTS RESERVED. Permission is granted for non-commercial downloading, copying, distribution or redistribution on two conditions: One, that some form of copyright notice is included in every copy distributed or copied, showing the copyright belonging to Vibrant Life, Burbank, CA, at www.oralchelation.com . The second condition is that the material is not to be used for any purpose contrary to the purposes and objectives of this site. This permission does not extend to materials on this site which are copyrighted by others.
