What treatment is available for osteoarthritis whilst on warfarin?

I have arthritis in my knees but its not too bad so no real treatment. Had acupuncture a few years ago and some exercises and seemed to be under control. However it is now getting worse and also has started in my hands. I am finding this very painful. Doctor said take paracetamol but guidelines say interacts with warfarin if more than 5 tablets a week (gp said no interaction!). My question is have you osteoarthritis and what treatment are you having. I have appointment next week with gp and would like to know what people are on.


13 Replies

  • I take paracetamol with no problems. Ibuprophen is the one you shouldn't take. Codiene is OK too I think.


  • Thanks bob - appreciated. Did you have to adjust your warfarin dosage as NHS etc says effects inr if more than 5tablets per week

  • Whatever you eat or take , try to be consistent and your INR will adjust. It is binging on things or suddenly stopping other foods or drugs which causes INR to fluctuate. I have never heard about your five tablets a week thing and take way more than that number.

  • Put "NHS paracetamol and warfarin" into your search engine and you get NHS page with a question about this. This is where my 5 a week came from. They say any more than 5 per week and need more inr testing. Marie

  • That's the trouble with the internet isn't it Marie .Too much information and not all of it correct. I have been on warfarin for 6 years and no DOCTOR has ever told me not to take too many paracetamol other than the usual dose of course. I have been prescribed it and tramadol for pain relief in hospital following prostate surgery and later hernia repair but always told I must never use ibuprophen,


  • Since being on warfarin my GP has said paracetamol is OK and has prescribed co-codamol (which made me sick) and now tramadol, which I haven't taken yet.

    My GP says it is not necessary to test INR level before/after new meds which I thought was important.



  • Thanks for reply Marion. See my note to Bob above. My gp also told me no interaction but that is not what the NHS website says and says more than 5 per week can have an effect on inr and additional testing necessary. My inr went to 4.3 this week and I think due to paracetamol. I have coaguchek machine so can do my own checks.

  • Thanks lallym

    I shall have a read up on paracetamol especially as I am on 10/12 week INR testing..



  • Hi Lallym

    I have never found that paracetamol affected my INR. As you have a Coaguchek I'd just check it once a week as you're doing and adjust as necessary. If you're on 4.3 you do need to cut your warfarin however and perhaps test every 2 days until it's in range.



  • Thanks mark - this is what I have done. Marie

  • Hi

    Like the others I have been on for years and have never been warned off paracetamol, in fact it has always been the drug of choice when I have had other complaints. I slef check and it has never affected my INR. As Bob said Ibruprofen is a no go.

    There are warnings on paracetamol because it only takes a dozen or so taken all at once to over dose.

    As Bob says sometimes the internet doesn't do you any favours


  • Thanks for responding Eileen and really interesting to hear all the responses. I agree completely that internet can throw up all sorts but this is the NHS website plus my inr going up. Anybody on any other treatments for osteoarthritis. Marie

  • My GP said it was OK to use cocodomol for my back and leg pains. I used to have Naproxen for this, which is an anti-inflammatory and a definite no-no apparently. No ill effects from the cocodomol so far but I don't take it on a regular basis - just when needed.

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