COVID-19 treatment options for those taking Warfarin

[olleberj]

Hello.

I have not contracted COVID-19, but most others I know have had it, and many treat successfully with Paxlovid.

I learned recently that Paxlovid interacts with Warfarin in that it suppresses the body's ability to metabolize the Warfarin, thereby possibly causing increased INR while taking COVID and Warfarin simultaneously.

This bothers me because if I am isolating at home recuperating from COVID-19 and taking both Paxlovid and Warfarin, I will not be able to monitor my INR and I won't know if I'm taking too much or too little Warfarin to treat my APS. (I am not able to use INR self-testing machines).

Has anyone had this problem? How have those of you with APS who also take Warfarin dealt with COVID-19 infection?

Any advice or information about your experiences is most welcome.

- Jeanette

[Ozchick]

You could change to LMWH while taking the anti viral-it's a 5 day treatment. I had no issues or side effects but I don't take Warfarin.

[Fra22-57]

Hi there.When I caught covid I didn’t take the anti viral so just had to wait til it had left me well.Maybe the interaction with warfarin was why I wasn’t allowed the anti viral.Hope you are soon well thou

[MaryF Administrator]

I would write urgently to your GP and all consultants involved in your care, (using PA's emails addresses marked for the intended medical staff, to trigger some joined up thinking, this will help reassure you that you are being monitored, as hopefully they will suggest something sensible for you. MaryF

[Ray46]

MIght also want to check out some of the previous threads on COVID and INR - it seems, anecdotally, that the infection itself will send your INR all over the place, and that effect (like long covid) can last for months afterwards as well.

A predicatable (as much as anything with warfarin) drug interaction with the anti virals might actually be the lesser of two evils, particularly if the anti-virals reduce duration of infection and reduce chance of after effects. Needs discussing with your doctors.

[olleberj in reply to Ray46]

Thank you. I appreciate your perspective.

[Dkjaffe]

I had COVID and took paxlovid. My INR was normal. 3.5- 4.5. I I had all 3 shots. My vivid was mild, but weird symptoms.

[olleberj in reply to Dkjaffe]

Thanks for your reply. Do you also take Warfarin?

[Tofino5]

I’m currently slowly recovering from covid. I’m on apixiban (Eliquis). I had to halve my apixiban dose for the 5 day duration of paxlovid plus three days afterwards. I was also told to delay taking my CGRP inhibitor Aimovig for at least three days after the paxlovid was complete.

It isn’t warfarin, but maybe someone else is reading this thread and is on a DOAC.

[GinaD]

I took paxlovid back in April. Searching my iphone, I do not see any unusual INR readings or appointments. during that month. Which is not to say my memory is accurate. But I do think(?) my INR went up a week or so AFTER finishing the paxlovid. I suggest indulging in more spinach and maybe a bit of chicken liver near the end of your script. I caught covid a 2nd time last week, (Grrrrrrr! I was wearing my mask! Not fair!) This time I am taking molnupiravir as my doctor says it does not interact with warfarin. Amd it seems to work. I am on day 5 of my 5 day treatment and this morning I feel 100 % normal. Warfrin interactions are bad, but Long Covid is worse! Glad you are getting treatment for that nasty bugger!

[olleberj in reply to GinaD]

Thanks for your reply. I’m sorry to hear that you contracted the bug despite wearing a mask. It’s good to know that you are feeling better. Take care, Jeanette

[Bloodredroses in reply to GinaD]

yes not fair. I stopped wearing a mask after 3 years fully outside , even went in a store, and got a virus is mild but lingering because on blood thinners I think . Took antibots. G P said 4-6 weeks to clear ! I am back to fully wearing my good N 85 masks in stores , always on buses . In crowded. Streets , my chest hates the pollution and cold air anyway .

I believe N85 and medical masks work. Why hospitals fully using them if not .

[user666]

although not quite as effective, Molnupiravir is the go to when paxlovid is counter indicative.

[Raw57]

I did not take it during my Covid 19 illness. I was in France. It is rarely prescribed there apparently. My INR was all over the place without it so I am not sure taking it or not taking it will cause problems. I did not check my INR until I was negative because I had to go to a local lab. I could barely eat and laid around doing nothing for 10 days so that might have made it worse. It all worked out. Now I have my own monitor so I will self test if I get it again.

I know its worrisome but hopefully you will stay infection free.

[KellyInTexas Administrator]

with a double mask- you should be able to test your inr. You cannot be turned away for a medically necessary test.

I had Covid and was put on paxlovid. ( the inr swings were not terrible.)

[Bloodredroses]

I have APS . if it’s a constellation, my Haematologist Professor during worst early days of Covid, of which her hospital being big was in front line, and blood DRs adapted the smaller oxygen machines, used when they ran out of the biggies. In a phone consult clinic told me to take my blood thinner ( Rivaroxaban ) ( and statin) every single day , and to never forget . As it’s a clotting disease , a blood thinner is the treatment anyway . Being on it probably is insurance not to clot . right? I just had the virus going around , with chest congestion. It was so mild , didn’t know . Congestion light but persistent . Had antibots to make sure it did not take a grip of chest . Sinus. I assumed again the blood thinners kept the virus and congestion ‘thin’ .

[Pooky7]

hi. I had Covid 2 years ago. I have always been on high vitamin D. I have been taking Vitamin C, zinc, Quercatin, and magnesium for years also. Along with many other supplements. ( I have APS, hemophilia B and limb girdle muscular dystrophy). My Covid was mild. I took melatonin to get taste and smell back in 2 weeks. My INR was a bit off for awhile, but no big deal. I have never got the shot for Covid. I don’t wear a mask anywhere. I eat a ton of blueberries daily and mostly organic. If I feel run down, I take more vitamin C. I haven’t been sick with any illness since Covid. I have school age kids that bring home “ germs”. I guess my advice is to see a naturalpathic dr and detox from heavy metals and boost your immune system I love going into my Drs office and having them scratch their head on why I am so healthy and gaining muscle strength with muscular dystrophy. God is so good. So talk with Drs and see what vitamins and minerals you might be lacking. Don’t fear. Don’t fear.