Coumadin For Injection
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Popular Questions
Healthcare Professionals: what do you think of a one-time IM Toradol injection for an elderly pt on coumadin? pt was warned to monitor for s/s of bleeding, pt needed pain relief, doc did not want to administer narcotic (delirium/fall risk)

Country Hick replied: "I would not recommend giving Toradol orally, or especially IM due to increased chance of bleeding, to somebody who is taking coumadin. Toradol is a non-steroidal anti-inflammatory similar to ibuprofen only much stronger. It can inhibit platelet function and increase the clotting time of blood. It is risky not just because of the fall risk, but for any injury where bleeding can occur. I would recheck with your physician for other types of medicatons that can be used for pain, for example tylenol can be used for milder pain. If the pain is more severe you need to talk to your physician and explain the situation to him/her."

Diane A replied: "Elderly people who need pain meds are a real problem--most NSAIDS (of which toradol is one) are relatively contra-indicated as are narcotics (due to significant altered sensorium). A one time dose would probably not cause significant bleeding (GI), although the patient could be over-coagulated. Sometimes a half dose of toradol (30 mg) is given to the elderly. It certainly can be a judgement call--you walk a fine line between the needs of the patient (pain) and the complications."

W W D replied: "Overall, I'd say the ketorolac is riskier than the narcotic, and pointing out the risk of the narcotic is just a rationalization. For a single dose, it's probably not going to be a lot of risk in any case, but I'd have to know more about the specifics of the case. Ketorolac has the highest risk of any of the NSAID's in terms of GI bleeding, and it's no more effective than ibuprofen, so question #1 would be why not just give a couple of Advil (or for that matter, the even safer acetaminophen). The interaction with Coumadin is a concern, and elderly people often have the addtional worries of cardiovascular and renal disease, which make ketorolac even less appealing."

ATTN: People who have used Lovenox or Coumadin..I have a question for you.? I just found out today I will be on blood thinners the rest of my life. I am currently on 5 mg of Coumadin daily. However, I had lovenox injections jointly with Coumadin in the hospital until it took effect. My question is, would you rather have the Lovenox injections or Coumadin pills for the rest of your life? I know the shots hurt like anything but they are weight based and your INR doesn't constantly jump around...I also hear that the injections are safer (not sure if that's true).

git r done replied: "i have been taking coumadin for 10 years,never heard of lovenox."

toots replied: "I'd much rather swallow a pill than get an injection in my belly every day!"

monkeyfullah replied: "Pills are better to manage that injections. However, you should be having regular blood test to check your INR and to make sure you dosage is correct. Lots of things can effect coumadin (warfarin) and increase your chances of bleeding such as taking medications such aspirin (salicylates) and co-trimoxazole and lots of other medications as well as alternative medications such as chamomile, green leaf tea etc. You should tell your doctor about what medications and alternative therapies you are on and watch carefully for any side effects of coumadin which include bleeding, bruising, black tarry stools, bleeding gums, red/orange urine etc and report these to your doctor."

I was taking Lovenox injections, for atrial fibrillation/ coumadin level too low.? Heart rate was 140, admitted to hospital, sent home 6 days later to take Lovenox injections twice a day. now I have large very very tender knot in abdomen, what can do to ease the pain. can't stand to touch my abdomen at all!. One intern said, just wait until it dissolves!

Erick A replied: "This is pretty common with Lovenox shots. You can place a warm compress to the area. Other than that, the intern is right, it will dissolve and be less painful. +this is for general information only and is in no way a substitute for seeking professional medical treatment or evaluation."

I would like to know if anyone out there has been on Coumadin/Lovenox therapy for treatment of a mild stroke? I was 6 weeks post-partum when I found out after having a stroke that I have a blood disorder in which the antibodies in the blood tend to clot my blood (Lupus-anticoagulant). I have been on Coumadin/Lovenox therapy for 1 1/2 months now and cannot reach a recommended PT/INR level between 2 and 3. Until my weekly pricks to check these levels is at this number, I must continue the Lovenox injections as a safety precaution because the Coumadin is not working well. I am now taking 12.5 mg ( I was on 10mg) a day. I guess you can say I'm frustrated because when I initially started this therapy I was told that I should be at the recommended level in about a week . Now at 1 1/2 months later I feel like a guinea pig trying a high dose(not helping) so now a higher dose (let's see how your body accepts it at this dose). I've kept up with the diet guidelines and really feel this is not the problem. If anyone knows about what I'm talking about please respond.

libbyn43 replied: "please, try not to get frustrated. i know it's hard, but once your doctor get's you leveled out you will feel so much better. medication is all trial and error. especially when it's coumadin. it just surprises me that he hasn't got you leveled yet. are you going to a heart doctor or your general doctor. please go to a specialist."

Keziah_indnJC replied: "Yes.I do somehow know your case ( we do the blood sample taking then processing it in the machine that will read the PT/INR of your blood ). You see, your case is mostly serological..meaning Lupus-anticoagulant is a problem with an antibody having to go against your blood clotting system.The role of your coumadin now is not to kill the Lupus anticoagulant but to have the normal blood function.. that is to make the blood not to clot as much as you do because this will cause thrombosis (clot that clogs your veins) the is why mild strokes happen.The right dose has to be achieved because the doctors don't want to make your blood too watery because it will cause bleeding tendencies.On the other hand if the dose is too strong then it will greater risk for thrombi that may lead to death.. (God forbid )Be patient..it is not that you are being experimented but you see the case is also difficult for clinicians. I myself..have encountered patients who have to undergo repeat prick test to determine also their bleeding and clotting time. Hope this helps.God bless"

hello replied: "Yes, and I have Antiphospholipid Antibody Syndrome (APS). The same disease that you have. You may be Coumadin resistent. But also there is a lot of information that the finger prick machines are not accruate for APS patients. They all carry disclaimers on them. So you may want your doctor to do a vein draw to compare them. Are you seeing a hematologist? They may want to do a Factor X essay and compare that to your INR/PT Typically most patients are kept at an INR of 3-4 with this disease. My INRs are hard to regulate. That is just part of APS. And since you are a woman, our hormones also play a role. Actaully, in the post partum period with the disease you are at some of the highest risk of clotting of than the pregnancy itself. Here is a wonderful beginners guide to APS:. Here is some basic information on APS: My INR is kept at 3.5-4.5 plus I take aspirin because APS can cause both venous and arterial clotting. I am also on Plaquenil. Do you keep a INR log book and medical symptoms journal? It is amazing the patterns we can find. There is a non-profit organization in the US that can help you. There name is APS Foundation of America, Inc. Their link is below. Good Luck!"

joe replied: "i too have started the coumadin "program" and have been on it for about 45 days. i started getting pricked every 2 to 3 days and am now up to every 2 weeks so hang in there you are not alone and sooner or later things will fall into place. my protime was 2.4 last week so it will work."

A question about Coumadin? Lately any little scab I have on my hands has turned into a little blood blister. I've had this happen a couple of times before, but only when I'm on injection Lovenox. I'm on coumadin now, and have been for about 5 years. I'm wondering, if my INR is really high, could this cause the blisters? My does just got increased the other week? Anyone know, thanks.

kcms0796 replied: "Coumadin is also a blood thinner so yes it could be from the coumadin and you need a dose adjustment. We have patients that have theirs adjusted weekly! Even though they had been on the same dose for years. You should probably get your INR drawn asap and call your physician and inquire as to what they want you to do. He/She may want to see you before having your draw done. Good luck."

Is Coumadin similar to Lovenox? When I get pregnant (hopefully soon) I will need to take Lovenox for a blood clotting disorder that I have (it only appears during pregnancy and has caused several miscarriages). After doing some research, I have discovered that Lovenox is very expensive (about 2000 a month). I will pay it if I have to, even if it means getting a loan. But, I am wondering if Coumadin works similarly to Lovenox...its a lot less expensive and not an injection, so my insurance will cover it.

mrodrx replied: "They both work to thin the blood but Coumadin causes birth defects. DO NOT take Coumadin if you are pregnant. That is the entire reason they want you to use Lovenox. It is expensive but it is worth the price to have a healthy baby. You also don't want to use Coumadin while breastfeeding because it will thin the baby's blood."

IRA replied: "It has to be an injection in your tummy fat part so that it can be released slowly in your system. I took Lovenox too ( but in Europe is named Clexane and is a lot cheaper). You can do the Heparin shots since they are cheaper , but you will need to do it twice a day. Coumadin is dangerous when pregnant , it is warfarin .Can cause serious bleeding to the fetus. Lovenox is enoxaparin-another kind of blood thinner is the safest thing to use to prevent miscarriage. Can you have Clexan shipped to you from smbody in Europe? I bought some in Greece and costs around 6$ each shot for the 40 mg (or 4000 anti IU) or 3$ for the 20 mg. (if I remember well) So in a month you spend about 200-300$ depending on your dose. I found Clexane is very expensive in the States too."

I had two heart attacks a couple of years ago and am on medication for the rest of my life.? I am currently experiencing problems with dreadful pain in my lower legs which doesnt abate with rest, swelling of my hands and feet, sometimes severe difficulty swallowing. I have had two previous DVT's both treated with 12 weeks of coumadin and heprin injections. I have also noticed a lump growing in my right arm which in the space of a month has gone from the size of a pee to a golf ball and causes some problems with bending, straightening and pins and needles...could these problems be connected?

M replied: "Yes. Go to your doctor!"

i_am2die4 replied: "I am sorry to hear, I wish i had answers for you, maybe you should see a docter especially for that lump... i honestly do not see the connesction, then again I had sharp pains in my elbow area and apparantly it was due to my upper back.... you just never know... Take care"

mlgable replied: "You need to see a doc ASAP as the leg pain could be another DVT or it could be a side effect from some of your medication etc. If it is a possible DVT you need to get this checked out now. If the clot were to break loose and travel to your heart the end result could be devastating to say the least. Head to urgent care and get this checked out."

GoBobbyRocks! replied: "In answer to your question: "I had two heart attacks a couple of years ago and am on medication for the rest of my life.?" I dont know if you have or not."

jack replied: "You have come to the right person, that is, myself, for advice. I too was suffering from cardiac distress. Now I am completely OK. In brief I give you the remedy: Stick to pure vegetarian diet. No meat, no fish, no milk, no oily food. Eat fruits and vegeables. Keep your weight low. Take one Vitamin E capsules 400 mg. and one Vitamin C tablet 500 mg. everyday after food. I guarantee within 4 days your pain in the chest will go away and you will be able to resume your normal activities. By the way, Yahoo is doing a great service to people by bringing people together to solve their problems."

kaushall7 replied: "You should go to your doctor,it may be side effects of the medications. For the lump,its serious you should go at once to the doctor."

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I recently was diagnosed with a DVT. If the anticoag meds don't dissolve it, how will it go away? I am on Lovenox and Coumadin. My stomach is very bruised from the Lovenox injections. Is this normal? 11 of Lovenos two times a day and 7.5 mg of Coumadin daily. I have teds also, but is it okay to wear them of the affected leg? Or will it cause the clot to break off?

nursekuba replied: "The bruising from the Lovenox is normal. Make sure you don't rub the area you just put the lovenox in. The doctors are going to keep monitoring your clotting and keep an eye on the clot. The clot will eventually break up in time. In the mean time, if you suddenly have shortness of breath or chest pain, call 911. Those are possible signs that it might have broken free and gone to your lungs or heart."

The mom replied: "The bruising and soreness in the abdomen after injections is unfortunately very normal. Use a heating pad on your stomach to help increase the healing. The anticoagulants will work, it will just take a little bit. They want to dissolve it fairly slowly so they don't risk it breaking off and moving into the heart/lungs/head. Be sure to take it as directed and do all the followup exams, and follow all the doctor's directions otherwise. My sympathies on the abdominal injection sites, I've given and recieved them, and there just isn't a better way to avoid the soreness afterwards. Belly muscles don't like being poked."

Jimmy replied: "Well, if the heparin and warfarin dont work to dissolve the clot, there are a few other options. They can try to bust the clot with tPA, which is called a thrombolysis. There are also compression stockings which could help as well."

Paragard vs Mirena after blood clot? I'm almost 6 weeks post-partum w/ third child (had to have my first c-section my water broke early and she was breech) and was hospitalized last week for a blood clot in my leg (I'm taking lovenox injections and coumadin aka warfarin)... My method of choice is the IUD. I want the paragard because I would rather not do the hormonal thing aka the Mirena. However my obgyn wants me to do the Mirena because she is worried about me bleeding too much with the Paragard since I'm on blood thinners. I've had the Paragard in the past and didn't have any problems with heavier menstruation. The hormones in the Mirena can cause blood clots (among other things) right? Also, my aunt who is 38 recently died of a massive heart attack which the docs attribute to her being put on bc pills (hormones, people) just a few days earlier... So I still think I should get the Paragard and NOT the Mirena??? Am I right and I already started my period last Thursday and they told me the Mirena needs to be inserted WHILE I'm on it....

another YA! replied: "id just get the paragard. i hate hormones and sounds like you dont need any."

Starsfan14 replied: "I researched this quickly just now. And from what I can see Paragard is the better choice. Mirena is not recommended for people with a history of DVT's. Did your doctor test you for clotting disorders? I say this especially since your aunt died. I am so sorry for your loss. I have a clotting disorder and I had my DVT when I was 26 weeks along with my first child. So I know all too well about the Lovenox and the warfarin. My doctor said that I could have an IUD after the birth of my first child while I was still on warfarin. She didn't specify which one, but I assume it was Paragard, but I wasn't interested so I didn't ask. I wish I could give you more of informative answer though."

sunshinyorange replied: "I've had both of them, and honestly, I HATED the Mirena--with a passion! I did bleed a *little* heavier while having he ParaGard, but it wasn't significant...and honestly, the flow wasn't that much heavier--my periods just lasted a day or two longer. They say the hormones in the Mirena stay in your uterus, and it's such a low dose that if any does get into your blood stream, it's not a big deal. I beg to differ with that. The 18 months I had it were the most miserable 18 months of my life (moody ALL the time, acne, drastic weight gain, etc.) My doctor pooh poohed it, but you know what--if you do a search, you can find many anti-Mirena message boards. If it were me, I'd definitely go back with the ParaGard. If I have a c-section, I'm having my tubes tied, but if I give birth vaginally, I'll probably go with either the ParaGard or that new Essure procedure. Have you read up on that? Sounds pretty neat, and very effective. The only drawback is that it's considered permanent, so if you want more kids in the future, it's not recommended. I'm going to ask my doctor about it at my next appointment. All they do is go up through your cervix, uterus and into your tubes and put in these little "plugs" (for lack of a better word) and scar tissue grows around them and won't let the eggs pass through. It's nice because they're not hormonal. I'm sure there's some type of catch ("If it seems to good to be true, it probably is...") but I'm still going to ask him about it! Do you have a history of blood clots, or was this just a one-time occurrence? Having surgery (especially a c-section where you spend a great deal of time on your back recuperating) is known to cause blood clots in the legs because you're not getting enough exercise/blood flow. If it was just a rare occurrence, I'd say you'll be fine to go with the ParaGard. Good luck to you. And congrats on your new little addition. :)"

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