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Dr. Andrew Rynne

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Suggest pain medication that can be used with Warfarin

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Dr. Prakash H Muddegowda

Geriatrics Specialist

Practicing since :2004

Answered : 2138 Questions

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Posted on Mon, 25 Aug 2014 in Hypertension and Heart Disease
Question: I have been on 15mgs of Warfarin for a year as a result of multi-embolisms in both lungs. I am slowly reducing and am now on 91/2 mgs one day and 9mgs the next. I have 7/8 discs that are seriously worn - too much seriously fast bowling - I am on Lozartin, Amlopidine and Doxasozin for high blood pressure over many years. I have two questions: I cannot take painkillers, even paracetamol because they react adversely with the blood pressure tablets and Warfarin, I am told. (I also bleed badly if cut, and have had a knee x3 full of blood which has now dispersed, I hope.) So I am in constant pain that varies from dull to acute 24/7. Secondly I usually cycle daily because impact sports are out of the question, but I seem to catch every damn virus going. I have been regularly to my hospital and GP and they have all been wonderful. But still I have these problems. I'm 70 next year - HELP please.
XXXXXXX
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Answered by Dr. Prakash H Muddegowda 1 hour later
Brief Answer:
Take protein and vitamin supplements.

Detailed Answer:
Hi,
Thanks for asking.
I am Dr. Prakash HM and I will be answering your query.

Based on your clinical history and comments, my opinion is as follows:

1. Your reduced immunity has led to increased risk of infections. Yes, impact sports at present is out of question, but moving around with slow walking will prove to be very helpful. Cycling is indeed very good. Also you can try water aerobics slowly.

2. To improve nutrition to improve immunity, you need to concentrate on a balanced diet or with nutritional supplements. Diet rich in proteins, vitamins and minerals like eggs, red meat, fish and pulses should help you in improving your nutrition. Additionally, nutritional supplements in market can also be taken.

3. Warfarin always increases the risk of bleeding, and you need to continue because of risk of thrombosis. However, paracetamol is not known to affect bleeding other than through causing liver damage. If pain is mild, you can definitely paracetamol on normal dosage. If pain is severe, opioid analgesics can be taken after a prescription from your doctor.

4. Cause of pain is not given. Looking at age, it might be back pain or osteoarthritis of knee. Exercises to improve muscle strength will reduce bone pains in the long run.

Take your medication regularly. Maintain a good nutrition and control your weight within the normal range. Move around outside too.

Any further queries, happy to help again.
Dr. Prakash HM
Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju
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