No No for Warfarin

[BernardS]

Does anybody know if Pomegranate juice is a no no like cranberry juice?

[bmand]

I wasn't a where that Cranberry Juice was a no no. Can you elaborate on this thanks?

[BernardS in reply to bmand]

Hi bmand

this got me thinking and I had to go back to when I was first diagnosed with AF many years ago. in a patient information leaflet from the AFA Association which I obtained at the time it lists Cranberry Juice as a 'medication' which increases the effects of Warfarin. Sits in the list between Clopidogrel (Anti-platelet medication) and Dexamethadone (Oral Steroid medication)

The reason I ask about pomegranate juice is because yesterday after eating half of a very juicy pomegranate when I self tested this morning the INR result was 4 points higher which is a huge jump for me from the 2.4 - 2.6 mark which I have been for years. If I continue with the juice I will probably have to adjust my maintenance dose which could be problematic as it is only 1½ mg per day and a ½ mg reduction is over 30%. Just rather avoid the juice.

[MarkS]

There isn't an interaction between cranberry juice and warfarin. See:

health.ucsd.edu/specialties...

I don't know about pomegranate but as it's not listed, I imagine there's not much.

The secret with getting a steady INR with warfarin is to have a steady and good intake of Vit K. So I have broccoli or spinach most nights. But I also take a Vit K2 tablet every day. Besides that I have a very varied diet as I love world food but my INR stays in range 98% of the time.

[seasider18 in reply to MarkS]

I posted this here previously

cranberryinstitute.org/HCP/...

amjmed.com/article/S0002-93...

[Hidden in reply to seasider18]

Oh joy! I can have cranberries! I have no idea why this has cheered me up as much as it has, not being the world's biggest cranberry fan, but it has

[seasider18 in reply to Hidden]

So its roll on Christmas? I'm not that keen on cranberries and the juice has too much sugar added to it.

Whether it is good for UTI's is also debatable according to the urologist who did my prostate procedure.

[psage in reply to Hidden]

cranberries make so many dishes better -- from granola and oatmeal, to poached salmon, to couscous, to sauteed spinach or green beans ...enjoy

[BernardS in reply to seasider18]

Thank you

most interesting site.

[psage in reply to seasider18]

the only place ive heard about prohibitions of cranberry is ..right here on the forum. My cardio and the Anticoag clinic both always emphasize 'consistency in the diet.' So ive been eating spinach and cranberries every day, and taking Vitamin k -Jarrow's M-7. My inr is stable and in range. Time will tell if this continues.

[seasider18 in reply to psage]

I always ate green vegetables when taking warfarin knowing that my dosage would be adjusted accordingly. I did believe it when told that cranberry was a no, no as it was on the literature that the hospital gave me just as grapefruit is with some medications. One thing that the INR sister at the hospital and the GP's nurse also said not to take was cod liver oil with warfarin. That was probably wrong as well.

[psage in reply to seasider18]

ive only been taking anticoagulants for a few months, i researched them thru med journals for about a year --before that i knew nothing. so that may explain why i had not heard about cranberry. i started with apixiban --eliquis -- and that product insert says 'no' to grapefruit. as i understand it --grapefruit has an effect on the liver's processing of certain drugs, including statins, for example. i havent heard anything re cod liver oil but im in the US. Medical recommendations for absolutely everything seem to change periodically and it's impossible to keep up with it as a patient. The pharmacists -- chemists? druggists?-- however have been very helpful and knowledgeable. And very accessible even by phone.

[seasider18 in reply to psage]

Cardiologist who put me on Amiodarone did not know that Warfarin dosage should then be reduced by 50% initially nor did my GP or practice nurse who was checking my ever rising INR. I had to research it myself. I then asked the pharmacist why she had not warned me. She said that she thought they would all have known that.

The patient is the last line of defence.

[psage in reply to seasider18]

yikes. their ignorance really doesnt make sense. Warfarin has been around for decades. My health service provider -Kaiser Permanente in the US -- has a special Anticoagulation Unit that starts the patient on low dose, tests 2x a week, and adjusts the dosage according to the results. I did not want that much monitoring, the labs cost $35 each time and that adds up to an unaffordable expense. But last month my INR spiked to 3.5 for no decipherable reason -- so then i was glad about the 'over-monitoring.' My cardio is not involved in this, he just gets the results. I talk to the pharmacists in charge of the monitoring, they email me my results and instructions.

[BernardS in reply to psage]

Hi psage

Lucky I am in UK. I self test my INR which is marvelous when travelling to different countries. After buying the tester, about £300 I get the testing strips (24) and warfarin tablets free because of my age.

[BernardS in reply to MarkS]

Thanks MarkS

very helpful.

[psage in reply to MarkS]

wow. thanks for the link --very helpful information. Mango -- who knew?? and Turmeric ...whoa. Supplements are very popular in the US. Yet the Kaiser Anti-Coag clinic monitoring my INR never asks about my consumption of these, or about Mango. thanks again.

[nickibmobile]

When I started on Warfarin 35 years ago the information said no cranberry juice, no grapefruit juice, limit green veg, no spicy foods eg curry. I have to say I ignored it like most 17 year olds would!! Over the years the list has become less restrictive as more is known about Warfarin and diet and I still love cranberry juice, broccoli and curries 😀