can you take asprin and warfrin with a history if clotting.

Hi MPN friends anyone taking both the above meds toghether would be interested to know.

thanks

Adiewon

[hunter5582]

Some people do take both, but there is a drug interaction. There is an intrinsic risk of bleeding when you combine an anticoagulant with an antiplatelet medication.

Monitor/Modify Tx

aspirin + warfarin

monitor INR, bleeding s/sx: combo may incr. risk of GI or other bleeding, incl. life-threatening (synergistic effects)

online.epocrates.com/intera...

Doing this combination requires dose titration and monitoring by a hematologist expereinced in treating MPNs.

[Hidden in reply to hunter5582]

Morning Hunter yes this asprin wafrin mix is not for me thanks for your feedback you have helped me no end . Once again l thank you very much.

Adiewon

[Buggerbear in reply to hunter5582]

Hunter, Is aspirin and Eliquis ok to be taken together?

[hunter5582 in reply to Buggerbear]

Bear in mind that i am not a doc. Just another guy with a MPN. Here is the information that I know. Please be sure to review your question with your care team.

Here is the drug interaction warning for aspirin - Eliquis (apixaban)Monitor/Modify Tx

aspirin + apixaban

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding, incl. life-threatening (additive effects)

online.epocrates.com/intera...

Combining aspirin (antiplatelet) with Eliquis (anticoagulant) comes with some intrinsic risk. Both drugs are "blood thinning" but work differently. Eliquis is one of the newer anticoagulants known as a NOAC. NOACs tend to have a lower bleeding risk than the older style of anticoagulants (DOACs).

The short answer to your question is that people do take aspirin and Eliquis together when the benefits outweigh the risks. This is a discussion you need to have in detail with your MPN Specialist. The doc can do the best job of explaining the risks/benefits of this combination of meds as it pertains to your specific case.

[Buggerbear in reply to hunter5582]

Thank you Hunter!! I have learned more from you and this wonderful group of knowledgeable and caring people than I have from my oncologist! I only started the Eliquis after I had PE's in my lung so guess the risk is worth not having additional PE's. So confusing when the Dr. tells me I'm high risk for clotting as well as bleeding. Thanks again!

[hunter5582 in reply to Buggerbear]

That definitely does make sense. With a history of Pulmonary Embolisms, prevention is VERY important. A more aggressive course of treatment is a good idea.

The comment about increased risk for both thrombosis and hemorrhage is intrinsic to all who have a MPN with thrombocytosis. In addition, we can also have microvascular symptoms (PLT interaction with vascular endothelium), which are not the same thing as thrombosis (PLT clotting). It is all about how the platelets behave.

Platelet behavior is quite involved. Hemostasis is very complex biochemical process. It needs to happen when coagulation is needed. it is a problem when it occurs when it should not. Thrombocytosis causes problems with both issues. The KISS version is that with MPNs, PLTs can be "extra-sticky" and clump together when they should not. PLT can also stick to the vascular endothelium when they should not. At the same time, when there are too many PLTs, there can be a decrease in the factors needed for coagulation (von Willebrand Factors). This can cause problems with hemorrhaging. Note again that is the KISS version. It is truly quite complex.

Here is a bit of information you may find helpful

Antiplatelets-Anticoagulants

medlineplus.gov/bloodthinne....

journal.ahima.org/page/know...

Hemostasis (really great presentation)(I had to use the rewind button a lot)

youtube.com/watch?v=SGzp9wq...(Not working as expected?)

All the best my friend.

[Buggerbear in reply to hunter5582]

Thank you so much Hunter! I sometimes have to replay several times for understanding and finding definitions of those big words, but I have been on a learning/research kick since I learned I had ET and PV! Appreciate you sharing your websites!!

[eastwood1932]

Hiya, I have ET and diagnosed after they found a number of clots in me. That was over 11 years ago and I have been on aspirin and warfarin (together with my HU of course) ever since. I was told to take them at opposite ends of the day, so aspirin with morning meds and warfarin with evening meds. It has worked fine for me. Yes some health people do a double take when they hear it but generally it’s fine

Janet

[Hidden in reply to eastwood1932]

HI Eastwood lm taking warfrin and was told categorically 3 years ago to avoid asprin. l find your experience interesting it appears the medical proffession have quite different ideas about asprin+warfrin.

[eastwood1932 in reply to Hidden]

that is the problem with medic, some say one thing, some say the other, one report says one and another report the opposite. All i know is it seems to be ok for me so far, and touch wood continues that way. As a low grade painkiller I use paracetamol

[PhysAssist]

Hi Adiewon,

We recently received this and on the strength of it, we discontinued aspirin use in all of our warfarin patients:

jamanetwork.com/journals/ja...

I hope that this was helpful.

Best,

PA4

[Hidden in reply to PhysAssist]

Very helpful indeed lm not taking asprin because I take wafrin and l always check herbal teas and the like for the substance acetylsalicylic (paracetamol)

Thanks Adiewon

[PhysAssist in reply to Hidden]

Hi Adiewon,

I'm glad it was helpful, and happy that you are careful, but i did just notice you posted this "substance acetylsalicylic (paracetamol)", which is kind of a mistake.

You are entirely correct in being careful to watch for AcetylSalicylic Acid, which is generic for aspirin [and is why we abbreviate it as ASA].

However, Paracetamol [which, if I recall correctly is what you across the pond call our drug Acetaminophen], is a non-aspirin pain and fever reducer, which does not affect platelet activity and/or clotting.- and is therefore considered safe for use with anticoagulation. Thus it's not considered an anti-inflammatory [or NSAID- Non-Steroidal Anti-inflammatory Drug].

So for your aches, fever, and headaches, it remains a viable treatment.

Sorry if I'm being pedantic, I just thought it needed to be clarified.

Best,

PA

[Hidden in reply to PhysAssist]

Thank you friend lve learnt so much from your reply. As usual on the site.

Adiewon

[PhysAssist]

Hi Adiewon,

You are of course so very welcome!

I learn so much here every day as well- and often, I'm prompted to further research by the questions and postings of everyone else here, so I'm also very happy to have found this site.

Best,

PA