Reasons why Cumadin level may be high?

Question

My sister takes cumadin, and her blood tests showed an extremely high level.
Besides overdose, her meds are controled, what could cause this? Her levels were 16!

thank you.
Sue C

Thanks. Her doctor does know this, and no she's not in a hospital, he sent her home.She had a second test done and it was 15.This was today.According to her Dr., only an intentional overdose or eating a TRUCKLOAD of green veggies could cause this.
She's in a controled enviroment and does not have access to her med.s.
I told her I would look for other things that might change her levels and get back to her.
I appreciate everyone's help!

Thanks again for the additional answers.
She was tested again today and her levels now are at 2.

I'm not sure what the name of the test is.She gets it every month to check the level of Cumadin in her system. I know normal levels are very low.Her Dr more or less accused her of taking an intentional overdose, he said it would have taken 10 pills (I don't know the mg) to get it that high,but in the enviorment she lives in this is not possible, nor when counted was her perscription missing any pills.She was experiencing very easy brusing and bled a LOT from a very small cut.
But it's all back to normal now.
We are all still very puzzled by this and pray it doesn't happen again!

Thanks for all the answers.She was very appreciative of them to when I read them to her earlier this evening.

God Bless,

Sue C

Answer 1

Her INR was 16? That's very high. I hope she safe in a hospital right now.

Many commonly used antibiotics such as metronidazole or the macrolides, will greatly increase the warfarin effect by reducing the metabolism of warfarin in the body. Other broad spectrum antibiotics can reduce the amount of the normal bacterial flora in the bowel which make significant quantities of Vitamin K, thus potentiating the effect of warfarin.

Ginseng is commonly used to help with fatigue and weakness. However, ginseng may increase blood pressure and heart rate and may increase bleeding, especially in people already taking certain anti-clotting medications such as warfarin.

Garlic (as a supplement, not in the diet) is commonly used to help lower high cholesterol levels, high triglycerides, and high blood pressure. However, may increase bleeding especially in people already taking certain anti-clotting medications such as warfarin.

Ginger is commonly used to help nausea and poor digestion. However, it may increase bleeding, especially in patients already taking certain anti-clotting medications such as warfarin.

Also, Aspirin and Plavix will cause an increased INR.

Basically, her doctor needs to review every single medication and supplement that your sister is taking. I'm sure he/she already is, but double check.

Edit: I'd suggest another doctor. Beyond that, it would be benefitial for her to be admitted to a hospital, even just to see if her levels came down there. If they do not, there are still treatment options available, even if just as a short term fix while the problem is sorted out. In the meantime though, this needs to be fixed. Call the doc in the morning and don't let him off the phone until he provides you with a treatment plan.

Edit:
The test is called an INR. I'm glad that it's down, sorry you couldn't find the reason. All the best!

Answer 2

I am confused by the number 15 or 16. It is unlikely to be an INR (treatment range is usually (1.5-2.5)and if it is the PT result - it is only slightly elevated (the normal range varies depending on lab 0 but is usually around 12 and treatment ranges would be approx. 14-20. Coumadin affects the Vitamin K dependent coagulation proteins produced by the liver. A dose of Vitamin K can counteract the overdose. It takes a while to work - and when a quicker response is needed, then Fresh Frozen Plasma is given. Coumadin is called a "blood thinner", but those of us working in the lab hate this term because it does not really "thin" the blood. It causes the blood to clot more slowly. This is extremely important if a person has an artificial heart valve, prosthesis like hip joints, fistulas for Dialysis patients, or a tendency to form blood clots.
The problem with coumadin is that the dosage needed is unusual and patient dependent. You do not take a certain number per day - but vary the dosge and often must break the pill and take 1/2 on certain days. It is not possible to calculate by height and weight how much is needed. A blood test must be performed regularly - every 2-4 weeks more or less.

Answer 3

Welll... an INR (international normalized ratio - the primary measure of the effects of warfarin in the blood) of 15 isnt any better than 16. Ive personally never seen or heard of an INR that high and would imagine that it isnt really survivable. The INR of people on warfarin for atrial fibrillation, artificial heart valves, etc is between 2 and 3.

Perhaps she got the wrong number. Otherwise, she would be in an ICU for sure.

Things that can increase the INR for warfarin patients include certain antibiotics as well as drugs such as aspirin

Answer 4

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Answer 5

Good question for HER to ask HER doctor!

My mother was on Cumadin for a very long time. Her (quack) of a doctor said she has "thick" blood! ? ! ?