Stomach bug and Warfarin: what should I do?

[Grundy77]

Caught a terrible stomach bug and wonder what to do, as I should stay away from Aspirin and Ibuprofen. Is the only thing Paracetamol? I got the shakes but no fever. Hoe to get some sleep. I am also on Levothyroxine, so will post in the other forum as well.

[Mrspat]

Ask your pharmacist. My local man is very good at knowing which OTC medications mix with my prescribed medications. The NHS are encouraging people to contact pharmacies before the doctor for this type of ailment.

[BobD Volunteer in reply to Mrspat]

Good advice! Diaoralyte for stomach if you have vomiting etc.

Bob

[ILowe]

My sympathies. Usual advice is to ride it out, take it easy, and keep up fluids, minerals etc. What is rarely mentioned is that fasting, intentional or not, can touch the INR. Not sure which way, because I rarely have this problem and I tend to just keep going on the normal dosage and risk it. I think it increases the INR, therefore it would be sensible to reduce the dosage 10-20% for a few days during the troubles. Can anyone else supply more accurate information?

[Hidden in reply to ILowe]

I disembarked a cruise ship 2 days ago after having been kept in isolation for 3 days with ' Novovirus ' . I was ' starved ' for 24 hours & could barely eat more than a slice of toast for the next 2 days. My INR went up to 3.8. Glad I had my Coaguchek with me.

I lowered my dose by 0.5mg daily & then by a further 0.5mg. as still 3.8INR

After reading your post I decided to test again ( 2 day interval ) My INR has gone up to 4.9 -- crikey!! I shall stop taking tonight & contact lab tomorrow.

I have still not got an appetite for any thing other than some fruit & a few crackers.

Looking on the positive side ...I've had a pretty good detox Lol but missed out on a tour of Dublin & Isle of Man TT Racing

Sandra

[ILowe in reply to Hidden]

Looking back in my notes, I saw that my INR had gone up to 5.8, which I regard as trivial. Under normal circumstances I would ignore it, test 5-10 days later, and only act if I get two results over 5.0. But here was an obvious reason. So I missed a day, then restarted at the normal dosage. Tested a week later: 2.2 (which for me is dangerous!) so I boosted by 0.5mg for two days, then normal. Next test was bang on: 3.4. (Note, I am working to the old advice for artificial heart valves which want me to stay in the range 3 to 4.5). The point is clear: fasting increases INR.

Have you ever made a note of the change when you miss a day? I have several examples, and each reduces by 40-50% so I know that missing one day of doses is enough. Other people may need to miss for two days.

[Grundy77]

Thanks for this helpful information. I have skipped one dose and wanted to return to normal dose today, but the diarrhoea returned just now. So I have called 111, waiting to hear what the GP tells me with regard to dosage of Warfarin.

[Grundy77]

Turns out that I should not worry and continue with my normal dose. Check INR in clinic next week