Warfarin

[BernardS]

Hi all

I know cranberry juice is a no no if on Warfarin. Is mango and pomegranate juice also a no no?

[Beancounter Volunteer]

Hi Bernard,

Mango is not a problem, but there are some reports of interaction between pomegranate and warfarin, (and other prescription drugs) I would avoid it to be on the safe side.

Be well

Ian

[BernardS in reply to Beancounter]

Thanks Ian

Not a consensus in replies.. One cranberry OK: one mango no and one mango OK. I am on holiday in India so if might be a combination of factors including prawns which jumps my IHR results in a week but now back to 2.8 with a much reduced dose, my normally dose is one and a half mgs so not much leeway when INR shoots to 4 plus in a week after a 2.4 and 2.7 in previous two weeks with no change in diet. Quite a godsend self testing.

Cheers

Bernard

.

[Rellim296 in reply to BernardS]

Warfarin users can be divided into groups. There's the sensitive ones like you who get into the therapeutic range on doses like 1 or 2mgs daily, there's the 5mgs or thereabouts a day lot and there's the top end on 10mgs a day or more. The latter are at an advantage as it's easy to make slight changes to the dose.

You can change your requirements by ingesting vitamin K in the form of green stuff to make your INR drop and your dose will go up. I think MarkS may have it fine tuned taking vitamin K in tablet form. If you drink alcohol, eat mangoes, and / or (I think) chick peas, liquorice and ginger your INR rises. Correct me if I am wrong here.

The other division is that some people, apparently, enjoy an almost static INR. Whatever they eat or do, their INR is always the same and they can test every three months and it hardly varies. Most people have a slightly wandering INR. At the far end are the unhappy ones who can eat exactly the same things day after day and there is no INR stability - quite the reverse.

The nearer one is to being wobbly with INR, the more one perhaps needs to avoid the dodgier things and it's my understanding that mango, pomegranate and cranberry all fall into the category of suspect.

[Rellim296]

Mango (along with a few other things) makes your INR increase.

[MarkS]

Cranberry juice does not have an effect but mango can increase INR. I'm not sure about pomegranate. See: health.ucsd.edu/specialties...

[seasider18]

I always wonder why the UK patient information leaflet says to avoid cranberries but does not actually say cranberry juice.

However now the FDA say that cranberries are OK with Warfarin.

cranberryinstitute.org/HCP/...

[seasider18]

I am surprised at the bleeding warning for Fish Oil/Omega 3 fatty acids