PTINR.com
Adverse Events Lecture Draws a Crowd
Tuesday, August 1, 2006
PTINR.com Staff
A standing room only lecture hall resulted from a presentation on adverse events associated with warfarin.
Douglas S. Paauw, MD spoke to a standing room only at the recent American College of Physicians discussing a medication older than most of the attendees – warfarin. A report from MedReport for CNN.com highlighted an emerging problem for patients on warfarin: increased use of herbal-warfarin (Coumadin ®) interactions are being linked to increased hospitalizations.
“Garlic, ginger and gingko biloba all increase the anticoagulation of warfarin while ginseng can decrease it” commented Paauw. Dr. Paauw spoke to a capacity crowd describing the emerging problem of herbal-warfarin interactions resulting in increased hospitalizations.
Dr. Paauw’s lecture included the identification of Bactrim® as one of the more severe drug-drug interactions but spoke of non-prescription products creating equal concern among prescribing physicians. Patients taking extra-strength Tylenol® pose a bleeding risk, Paauw commented patients who take 9 grams (2 or 3 tablets/day) of acetaminophen “should have their INR checked every four or five days.”
Absorption of medications including thyroid-stimulating hormones presents a clear danger of accentuating warfarin’s effect. More frequent monitoring is recommended as INR results, while stable for weeks and months can escalate rapidly. “You can have a patient who is doing nicely with TSH maintained at 2 or 3 and then suddenly it goes up to 6,8,12, 14” commented Dr. Paauw.
PTINR.com provides patients and professionals a forum for potentially dangerous interactions between food, over the counter medications and herbal preparations in our “Interactions” section. Weekly testing prevents INR test results from rising or falling to dangerous levels allowing earlier, professional intervention.