Azithromycin and Warfarin

[Monterey]

I just finished a 5 dose treatment pack 250 mg of Azithromycin .My INR was 1.9 9 days ago and now it is 3.2 .I am .The assistant looked at my INRS and told me that a Pharmacist would call me back .Two hours later I am still waiting and my nerves are not happy .I have researching and discovered that this medication can really raise your INR and that you could bleed from the combination .
Please if anyone has any advice please post it for me .My INR was checked yesterday and I bruised which I never do .How often should I demand to be rechecked ?They always want me at 3-4 weeks but I only been in range 2 times since November 2009 post TKR and PEs .The rest of the time its been around 1.5 to 1.9 .

[Laurie]

Monterey,you should be checked every week until your INR is in range. You should also be checked more frequently if you have to take any other medications that could interact with the coumadin. Once you are in range, you can be checked monthly.

[Marie M]

I am about to take my last 500mg Azithromycin pill. I was given a prescription for 7 days to combat acute sinusitis. The doctor never mentioned that it might affect my INR. I might need to go get that checked. I have been feeling really sick and tired since on coumadin. Does coumadin seem to affect your immune system? Are you coming down with more colds and just feeling terrible most of the time since on coumadin? I'd prefer to hear from those that take coumadin. No disrespect doctors.

[Angela]

Hello Marie,

I have been on coumadin for about 3 1/2 years now, and no, I am not a doctor :).

Was the doctor that prescribed the Azithromyin the same doctor as your coumadin managing doctor?
If yes, I would always ask him/her when he/she prescribes any new medication if it will affect your INR.

If it was a different doctor, make sure they communicate with your "coumadin doctor" or you need to call the "coumadin doctor" and check with them for any possible interactions.

Also, some pharmacies have software that automatically checks for any interactions. My pharmacist always points out any potential conflicts. I happen to go to Walgreen's but I am sure many other pharmacies have the same services.

What I have found is that it really pays off to educate yourself and ask your doctor(s) a lot of questions. There is no such thing as a "dumb question!" The more you know about your condition and medications, the better you will feel.

As for coumadin affecting my immune system, I have not found any difference, and I haven't had any more colds or infections of any kind than normal. In the beginning of my coumadin regimen, I used to be tired a lot, but then I had PEs and other conditions so I can't say it was caused by the coumadin.

Hope this helps, and hope you feel better soon! All the best, Angela

[sally]

I am on coumadin now for 6 weeks and I have gone from one cold to flu to another. In my own thoughts I am not sure if the coumadin is lowering my immune system or if the laying around inactively with my leg elevated is the culprit or all the visits to the hospital for blood tests and getting exposed more. Maybe its a combination of all of them but it sure sucks!