Coumadin and NSAIDS

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DianeW - 20 Aug 2005 15:27 GMT

Hello! I've been in lurking mode this past month. Just haven't been
feeling too well with all the med changes I've been thru. Turned out
I'm very anemic and the dr was worried about GI bleed. So I had to stop
my mobic and do a stool test for occult blood which took 10 days of not
eating certain meds and foods before I could give samples to the lab.
So I'm off Enbrel, Arava and Mobic....need I say more about how I feel!
(By the way --tests came back negative)

During this time I was still feeling really wiped out so I stopped my
lasix since they had taken me off the mobic thinking I didn't need it
any more and my bp went sky high - 160/110! Won't do that again! I did
feel better off the lasix, not so drained and dizzy. Dr put me back on
another bp med, my old standby Maxide and was feeling better but not
100%. (like we ever are) Was able to start iron and vitamins again as
well but still not mobic. So I've got iron, vitamins and 3 shots of
Enbrel under my belt and talked the dr into letting me go back on 1/2
dose mobic yesterday. Woke up today all dizzy again! Think this might
be the culpret!

So my question is this: Anyone know what other NSAID I can take with
coumadin? I was doing fine on Bextra don't ya know. Those are all
history and the dr had told me that I could only take CoxII with
coumadin. Is this true or what? What do you others on coumadin take?

I'm really sorry I havean't been more supportive to everyone this past
two months but it's been everything I can do to stay awake. Oh - and
my son left for college this week. Albiet only abut 5 miles away it's
still very weird without him here. At least he was thoughtful enough to
leave a friend of his in his place until Sept 1st! LOL

Thanks! DianeW

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spodosaurus - 20 Aug 2005 17:18 GMT

> Hello! I've been in lurking mode this past month. Just haven't been
> feeling too well with all the med changes I've been thru. Turned out
[quoted text clipped - 14 lines]
> dose mobic yesterday. Woke up today all dizzy again! Think this might
> be the culpret!

Enbrel is an immunosuppressant and can also suppress bone marrow
function. How anaemic were you? What was your haemoglobin level? Are any
other cell lines affected?

> So my question is this: Anyone know what other NSAID I can take with
> coumadin? I was doing fine on Bextra don't ya know. Those are all
> history and the dr had told me that I could only take CoxII with
> coumadin. Is this true or what? What do you others on coumadin take?

CoxII inhibitors don't block platelet functioning like other drugs. If
you're on coumadin, an anticoagulant, you'll want your platelets working
as they should to bring normal clotting when necessary.

> I'm really sorry I havean't been more supportive to everyone this past
> two months but it's been everything I can do to stay awake. Oh - and
[quoted text clipped - 3 lines]
>
> Thanks! DianeW

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DianeW - 20 Aug 2005 17:47 GMT

>Enbrel is an immunosuppressant and can also suppress bone marrow

function. How anaemic were you? What was your haemoglobin level? Are
any
other cell lines affected?

Hmmm -- Not too sure. My numbers for the hemoglobin were in the high
nine's to start out with and now are up to 11 without supplement. The
thing that concerned my rheumy was the MCV I think it is called. That
was also low. I'm always a little anemic and it was the MCV number
that concerned her because of the thing that can happens with RA and
that I word that I don't want to spell out cause I know everyone has it
blocked! (but if it were a machine you would use it to press your
clothes.) She wants me to go get more blood work done by a
hemotologist or my family doc who did a bunch of blood work and I'm
waiting for it to be sent to her I guess. I don't know. I'm very
confused with all this.

As far as the NSAIDs go, are you saying that the non-COX II stop the
platelets from working? Diane

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spodosaurus - 20 Aug 2005 18:19 GMT

>>Enbrel is an immunosuppressant and can also suppress bone marrow
>
[quoted text clipped - 4 lines]
> Hmmm -- Not too sure. My numbers for the hemoglobin were in the high
> nine's to start out with and now are up to 11 without supplement.

That's not too terribly low, at 11, for an adult female but it is a
couple of points below the normal range. You'd be really feeling it in
the nines, though. I like to be transfused when I drop below nine.

> The
> thing that concerned my rheumy was the MCV

Mean cell volume.

> I think it is called. That
> was also low. I'm always a little anemic and it was the MCV number
[quoted text clipped - 5 lines]
> waiting for it to be sent to her I guess. I don't know. I'm very
> confused with all this.

It can be very confusing, but it's important to keep on top of it. I'd
request copies of your reports. Not only is it good for keeping detailed
medical records, it's also a basis for learning what each of the results
means. With more blood work she may suggest some 'mineral'
supplementation ;-)

> As far as the NSAIDs go, are you saying that the non-COX II stop the
> platelets from working? Diane

Some of them, like the Cox I inhibitors, do, yes. This would increase
your risk of bleeding. I can take Celebrex because COX II inhibitors
don;'t have the same effects on platelet function (as I have virtually
no platelets left).

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Diane - 20 Aug 2005 17:23 GMT

hi diane,
sorry you haven't been feeling well. balancing meds is no fun. i still
take celebrex 2-4 times a week with my doc's ok, but i'm only on 2 mg
coumadin. with the move, i've needed the celebrex desperately. if you
find another solution to this sticky problem, let me know.

diane c

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DianeW - 20 Aug 2005 17:51 GMT

Celebrex was the first COX II I tried and I honestly can't remember
what my side effects were that made me stop taking it. But I then went
on Vioxx which sent my BP soaring and then Bextra which was fine other
than swollen ankles. I think it might have been stomach problems with
Celebrex. I take 2.5 mg coumadin 4 times a week, and 5 mg the other
days. But I really need an NSAID. I know what you mean about really
needing it with the move. I had an awful time helping Nick this week.
In fact, I didn't even go to the college apt until 7 at night. He and
his friend did it all themselves and I went over to smooth out the
edges in the evening. Even that was very difficult. I guess it's time
to let him do it on his own anyway.....sigh....(feeling a little sad
about it today.) DianeW

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Squirrely - 22 Aug 2005 21:07 GMT

Diane W,

I sure hope you can find something that works for you. I hope you get to
feeling better soon. You are in my thoughts even when I am not on here
saying so.

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Love and hugs to all
Good thoughts coming your way too.

Squirrely Jo

> Hello! I've been in lurking mode this past month. Just haven't been
> feeling too well with all the med changes I've been thru. Turned out
[quoted text clipped - 27 lines]
>
> Thanks! DianeW

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