Just had heavy cold with high temp. For two days I took 4x2paracetamol . How will this affect my warfarin?

[mays10]

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Hi Mays10. Well done, paracetamol is the pain relief medication which will have least effect on your INR level. If these were the standard 500mg tablets then 8 per day is the maximum recommended dose for anyone. Two days is not a long time but it would not be good to keep at this dose for a long spell. People's INR response to Paracetamol seems to vary but most that I have come across have reported a small increase to INR from Paracetamol suggesting a slightly lower Warfarin dose for a day or two to correct it.

I would not worry too much about a major effect on your INR but it would be a good idea to check it (or get it checked) fairly soon to be on the safe side. Do remember that many other cold cures such as Lemsip type products also contain Paracetamol and the Lemsip Max has equivalent to 2 x 500mg tablets in each sachet. If you have taken these as well then even more reason to get the INR checked again sooner rather than later.

Hope the cold is better now; they can make you feel miserable!

[mays10]

Hi PBirt Thanks for your reply. I am starting to feel better and have had only 2 Paracetamol today...hopefully won't need any more. I have only been on warfarin for 8 weeks and last couple of weeks my INR has been decreasing so they have been giving me a slightly bigger dose. I was tested today and was only 1.9 ! ....too soon after my paracetamol to raise it. They have once again raised my dosage and told me not to worry about amount of paracetamol as long as I don't continue on such a high dose..as you said also. I have not to be tested again for 10 days......I thinks that's too long!

[gizmomaven]

Hi. In anticipation of every requiring pain relief medication, asked both my pharmacist (who is the correct person to ask in the first place) as well as my GP. Both confirmed that the best pain relief medication in our circumstances is co-codamol with the breakdown of 8mg codein/500mg paracetamol

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Hi mays10, welcome to the club where you will find many friends to talk to about your warfarin therapy. PBirt has already given you some excellent advice and it always seems to be spot on. For somebody who's only been on warfarin for 8 weeks you appear to already have a good understanding of the need to maintain your therapeutic range. Too low and you could become subtherapeutic i.e. your warfarin therapy is not working and you could suffer further blood clots and too high and you could suffer excessive bleeding. Therefore, you are right to be concerned and in my opinion 10 days is far too long and you must look after your own well-being. It is well know that the anticoagulant clinics are unable to cope with the increase in the number of people taking anticoagulants and are unable to offer a better service. Most clinics are only able to maintain patients INR range at 60%, which they call the Gold Standard. However, patients who self-test and self-dose can achieve 90% in range and they therapeutic time range (how the warfarin is working) over 90%. I believe we must take responsibility for our well-being and be supported by our GP's. I became subtherapeutic due to the long periods between my INR tests and finished up in hospital (chest pains) for 4 days while they raised my therapeutic range to a safe level. I went out and brought an INR monitor and told my GP that I wanted to self-test and self-dose as I believed my anticoagulant provider could not look after my well-being. Considering my recent hospital stay due to lack of care, he couldn't refuse my request and actually seem well aware of the problems with the anticoagulant provider or maybe I've got a excellent GP who understands my needs. Please keep in touch and meanwhile, have you had a free copy of the ACE magazine?