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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes An Elevation In The INR Level After Taking Pepto- Bismol?

I am on warfarin & have had severe dirarhea for days. Took pepto bishop for the nausea, stomach cramping, & distress. My INR was 6.2 today. Which caused the elevated INR, the watery stools or the medication I was taking to stop them? I am to hold warfarin for 3days & only take 5mg on Monday. Recheck ONE on Tuesday. Please explain this to me.
Tue, 6 Feb 2018
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General & Family Physician,  's  Response
Hi & Welcome.

It is due to a harmful interaction between the two medications taken.

Taking Pepto-Bismol together with the anticoagulant drug Warfain may increase the risk of bleeding resulting in easy bruising, red or black, tarry stools; coughing up or vomiting fresh or dried blood that looks like coffee grounds, severe headache, and weakness.

The target International Normalized Ratio (INR) range while taking Warfarin should be in the range of 2.0–3.0. The INR of 6.2 in your case is elevated apparently due to increase in the level of Warfarin in the blood caused by harmful interaction with Pepto-Bismol.

When the INR is higher than the recommended range, it means that you have an increased risk of bleeding.

So, avoid taking over the counter medications or certain foods while taking Warfarin and consult your treating doctor if you suspect any signs and symptoms of bleeding as mentioned earlier.

Hope these answer your queries.
Best regards.
A feed back is appreciated.


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What Causes An Elevation In The INR Level After Taking Pepto- Bismol?

Hi & Welcome. It is due to a harmful interaction between the two medications taken. Taking Pepto-Bismol together with the anticoagulant drug Warfain may increase the risk of bleeding resulting in easy bruising, red or black, tarry stools; coughing up or vomiting fresh or dried blood that looks like coffee grounds, severe headache, and weakness. The target International Normalized Ratio (INR) range while taking Warfarin should be in the range of 2.0–3.0. The INR of 6.2 in your case is elevated apparently due to increase in the level of Warfarin in the blood caused by harmful interaction with Pepto-Bismol. When the INR is higher than the recommended range, it means that you have an increased risk of bleeding. So, avoid taking over the counter medications or certain foods while taking Warfarin and consult your treating doctor if you suspect any signs and symptoms of bleeding as mentioned earlier. Hope these answer your queries. Best regards. A feed back is appreciated.