question-icon

Does Percocet cause supratherapeutic INR and bad bruising?

default
Posted on Wed, 20 May 2015
Question: Can I just ask one question for an answer for now.? My INR was off the charts on Monday. With a finger prick they could not get a reading after trying 3 times. I take warfarin 6mg 6 days a week, 4mg 1 day. Nothing has changed except I have been taking percocet 5-325 3 times a day. Is the percocet what is causing the INR to be so high and I am covered with bruises. This is just a condensed version of a question I asked earlier that has not been answered.
doctor
Answered by Dr. Hardik Sanghvi (50 minutes later)
Brief Answer:
It is due to interaction between warferin and percocet.

Detailed Answer:
Hi, dear
I have gone through your question. I can understand your concern.
Your INR is increased and it leads to bruise.

You are taking percocet. It contains acetaminophen and oxycodone.
Acetaminophen is known to interact with warferin and causes supratheraputic INR. It is due to altered hepatic metabolism.

So you should avoid the combination of acetaminophen with warferin.
Either stop the acetaminophen or if it is needed then change the dosage of warferin and monitor the INR.

Consult your doctor and plan accordingly.

Hope I have answered your question, if you have doubt then I will be happy to answer.
Thanks for using health care magic. Wish you a very good health.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Hardik Sanghvi (44 minutes later)
Thank you for your info. THE
coumadin clinic I go to is affiliated with all my doctors. I am told to call them with any changes that could effect my INR. I did call them and they said percocet would not interfere with my INR. Even when they were getting the high readings they said the same thing. I asked the cardioligists office if they couldn't give me something to bring it down such as vitamin K. Their answer was if I start to bleed internally go to the ER otherwise have it checked Fri., the INR. You are saying
the 325 would effect the INR.
I am at a loss here. I certainally do not want to bleed internally, I want the INR down and I need the percocet for back pain.
doctor
Answered by Dr. Hardik Sanghvi (12 minutes later)
Brief Answer:
Acetaminophen definitely affect INR is some patients.

Detailed Answer:
Hi, dear
I have gone through your question. I can understand your concern.

Acetaminophen definitely affect the INR in some patients. It is low dosage but still it is possible.

If you need to take acetaminophen then its ok you should adjust the dosage of warferin. And you should take vitamin K to control your INR right now. It is antagonist of warferin. It will control your INR and saves you from internal bleeding.

Monitor your INR closely till it becomes stable and normal.

Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Hardik Sanghvi (39 minutes later)
Is vitamin K available to me or is it a prescription? They told me at the coumadin clinic that they no longer use it. I did have a bad reaction to it as a shot a few years ago,
Thank you for all your answers. Please answer this and I will sign off as it is past my bedtime!!
I feel like my hands are tied, I am very concerned. Maybe I should just go to ER.
Again Thank you.
doctor
Answered by Dr. Hardik Sanghvi (5 minutes later)
Brief Answer:
It is prescription based medicine.

Detailed Answer:
Hi, dear
I have gone through your question. I can understand your concern.
Vitamin K is prescription based medicine. So you need prescription. Moreover if you have history of reaction to vitamin k injection then you should not take without observation. You can take it under observation. Or you can change the dosage of warferin according to your treating doctor's advice.

Hope I have answered your all queries.
If you still have any questions then feel free to ask me. I will be happy to answer.
Thanks for using health care magic.
Wish you a very good health.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Hardik Sanghvi

Hematologist

Practicing since :2008

Answered : 7040 Questions

premium_optimized

The User accepted the expert's answer

Share on
Does Percocet cause supratherapeutic INR and bad bruising?

Brief Answer: It is due to interaction between warferin and percocet. Detailed Answer: Hi, dear I have gone through your question. I can understand your concern. Your INR is increased and it leads to bruise. You are taking percocet. It contains acetaminophen and oxycodone. Acetaminophen is known to interact with warferin and causes supratheraputic INR. It is due to altered hepatic metabolism. So you should avoid the combination of acetaminophen with warferin. Either stop the acetaminophen or if it is needed then change the dosage of warferin and monitor the INR. Consult your doctor and plan accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.