I was recently prescribed Tamsulosin for Prostate problems.
After a couple of weeks I had to have my regular INR blood test for my Warfarin levels.
After taking Warfarin for nearly 20 years with all readings within the therapeutic range of 2- 2.5 my results showed a reading out of range at 3.3.
I had an urgent call from the hospital lab asking me what I might have recently changed in my lifestyle and the only thing I could think of was starting the course of Tamsulosin. I was asked to miss a dose of Warfarin and to see my doctor.
I have an appointment set up for a couple of weeks time but in the meantime wonder if it is worth continuing with the Tamsulosin as so far I have had no benefit regarding my Prostate problem.
Has anyone else had a similar experience?
Pete
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pottypete1
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I've been on Warfarin for almost 15 years ( although I did have a 6 month disaster with Edoxaban ) and like you I've been in range ( my INR Theraputic range is 2.0 to 3.0 with a specific target INR of 2.5 ) for something like 92% of that time. Generally I swing between 2.2 and 2.7, occasionally such as the other day I hit 3.2 for no reason at all. Probably food ! All I did was reduce my dose of Warfarin by 1 mg a day for 3 days.
From your wording in your post I have to assume that your INR is carried out by your surgery... ?? INR Clinic. I don't, I have my own device and self test at home, anytime I want to, and so long as I report in my INR to my surgery INR clinic on an agreed date - everyone leaves me alone. Ideal !
My personal view ( after about 15 years ) is don't suddenly switch on and off food or other medication. The one outstandingly clear thing about Warfarin I've learned is it just loves consistency, consistency and more consistency. So I reckon stay with the Tamsulosin, don't panic - it might not be a reaction to Tamsulosin, it might just be a food you've eaten. What I'm hopelessly trying to say is ........ it might be a food, or even an ingredient of food you've eaten OR it might be just a settling process of your body to the new drug. Look your new INR is 3.3 which is out of range a tad ......... it'd be a damn sight more worrying if it dropped to 1.3 . At 3.3 your blood is a bit on the thin side so there is a bleed risk slightly higher than normal. Equally, if it were 1.3 your blood would be thicker than it should be for a Warfarin user. Hell, 1.3 is almost a normal persons blood.
In anycase, you've been prescribed Tamsulosin for a Prostate reason, don't start messing about there ! Grit yer teeth and stay with it for a few weeks ..... its not long to go really in the grand scheme of things - look lets just argue, that if you do what you say and cut out the Tamsulosin for a few weeks it might well de stabilse your Prostate. I wouldn't do that. I'd rather have thin blood and my medication working on my Prostate as is planned, than have correct INR blood and a destabilised Prostate.
As a matter of interest for you, did you ever have it explained to you why you were being prescribed Tamsulosin and/or what effects the prescribing medic was expecting. If not, you could always ask your friendly local pharmacist what the benefits are from taking it. Have you looked at the bit of paper in the packet to check out known side effects. Normally the bit of paper says stuff like, side effects, common, Uncommon and rare . Was this prescribed by a Consultant level medic or just a GP. ? I wonder.
I take for my Prostate - (along with a range of other drugs for my BP and AF) - Finasteride. My Prostate was considered enlarged, but not excessively so a few years ago. Not had a problem since.
My apologies for rambling on and on ... try not to panic a fret over this glitch, I'm really sure its just a settling down adjustment. I must say - for no other reason - than an idle comment, this is one of the great benefits from having ones own INR testing device at home - you can take these tests anytime you like and it helps in stressful situations. If I had a reading like now - I'll just take another test after a few days and see what my INR is, then again a few days after that. In my experience, any change in INR is usually very slow, so again, stay kool ! Don't panic.
Another thought - I was prescribed my 5mg Finasteride to be taken in the morning. I am wondering when you were prescribed your Tamsulosin to be taken. Sometimes the time of day when drugs are to be taken influences outcomes. Fer instance, when I first started on Bisoprolol I developed random, full flow nose bleeds. I had been prescribed to have it in the morning. Went back to my GP and she just said take it at night ............. never had a nose bleed ever since ... ever ! Just sayin' .
Let us know how things go for you Pete, its always good for us Warfarin users to acquire other folks experiences. May The force Be With You.
I guess from your greeting you are from down under.
Thanks for the reply to my post.
You are right I do not test myself, this option has never been offered. I have been so stable that a three monthly test by the hospital was all that was necessary up until last week.
Yes I do understand the reason for the Tamaulsin and what it is supposed to do for me. Maybe it will take a while but so far no change.
I do also understand the effects of food on the efficacy of Warfarin I have been taking it for 20 years plus and have always had an INR reading between 2 & . I do not vary my diet so would be surprised if food has affected my INR result.
Don't worry I won't panic.
I do panic if I get AF it always plays mind games. However for some time now this has been under control after a series of Ablations covering a period of 10 years.
I was told to take the Tamsulosin in the morning after breakfast, I take the Warfarin in the evening so when I had the blood test it was nearly 24 hours after taking Warfarin which suggests that if it is the Tamsulosin that affected my INR it has the effect of raising the coagulation level not lowering it.
By the way my understanding is that Warfarin is an anticoagulant and although commonly described as a blood thinner this is not technically correct.
My Pharmacist and my Cardiologist have both suggested changing to to one of the newer medications for anticoagulation but I am going to discuss this all with my doctor next week.
Thanks for your support I will try and let you know how things progress.
Hi Pete. I was prescribed Tamulosin for prostrate problems and Tamulosin is a muscle relaxing drug the idea is that the prostrate relaxed helps with the usual difficulties with passing urine and many trips to the loo especially during the night. For me the drug didn't help one but and even worse it caused a problem called "Floppy Iris Syndrome" which in effect caused the Iris to collapse when under going cataract surgery a couple of years after starting Tamulosin. I stopped taking Tamulosin and underwent a procedure whereby steam is injected into the prostate the procedure is called "Rezum" and is freely available on the NHS and over a few days the prostrate shrinks,. The procedure is just day surgery and that was just over three years ago and no problems since. I don't use Warfarin, but I am on 5 mg Apixiban. I am a 77 year old in permanent AF.
Sorry to hear about the "Floppy Iris Syndrome" I think I read something about that.
Thanks for the tip about "Rezum" I then read up about it and it sounds a bit daunting. I read that you have to have a catheter for some days and I have not ever got on well with them often giving my an UTI. I will keep an open mind.
Sorry to hear you are in permenent AF although maybe you have learnt to live with it.
Not easy getting old is it. I am the same age as you.
My EP suggested Apixaban as did my pharmacist so may see what my doctor says about that option.
I don't much like the side effects of Tamulosin right now but maybe I have to give it time.
I'm on tamusulosin and warferin ,sometimes it does change but I think it's more from food or lifestyle ,mine has jumped up occasionally but it's usually regular and within range 2--3 . Once I drank gin and tonic and it shot up to 4 ,that was due to the tonic that contains quinine, mind you I did have a few ,
I don't think is is food or lifestyle as nothing has changed, I have a similar meal each day of each week. I remember having a G&T but gave up alcahol a few years ago to give my EP a fighting chance of success with my 7th ablation - it had the desired effect.
Been taking Tamsulosin (and 5 mg of Tadalafil) for over 14 years for BPH. Never taken Warfarin, but was on Xarelto for a year for persistent AFib. Several times throughout the last 14 yrs have had out of range readings from 3.2 to 8.4 which had the urologists wanting to do biopsies for the higher readings. Doing some research I found out of range readings can be caused by aging, inflammation, infection, diet, sexual activity among others. Those readings are usually temporary and return to the "normal" range after some time, which all of my out range readings did later.
Once of my instances of high readings took about 4 months to return to normal range.
My readings of 6+ and 8.4 had the MD's wanting to do biopsies but I asked them to wait and do more blood tests later and luckily both came back in the normal range again.
Most urologists now don't order further testing until readings are 4 or more.
Tamsulosin relaxes the bladder sphincter to allow better emptying. It has some useful effect in many but is no wonder drug.
There are receptors here, there and everywhere so tamsulosin likely affects blood factors in your case. There are a few alternatives but all work similarly.
I've been on warfarin since 2009 and 6m ago started on Tamsulosin after radiotherapy for prostate cancer. I've been in 2-3 range for 99% of the time on warfarin and I haven't noticed any change. I've just taken my latest test this evening - 2.4, it was 2.5 2 weeks ago, so very stable.
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