warfarinfo

Warfarin Institute of America

DEDICATED TO YOUR HEALTH SINCE 2000

ASPIRIN INTERACTIONS WITH WARFARIN (Coumadin, Jantoven)

Brand Names: Bayer Children's Aspirin, St. Joseph Adult Chewable Aspirin, Aspergum, Genuine Bayer, Empirin, Genprin, Arthritis Foundation Pain Reliever, Maximum Bayer, Norwich Extra-Strength, Ecotrin, Halfprin 81, Heartline, 1/2 Halfprin, Bayer enteric Coated, Easprin, Extended Release Bayer 8 Hour Caplets, ZORprin, Bufferin, Bayer Buffered Aspirin, Asprimox, Buffex, Adprin-B, Magnaprin, Ascriptin, Extra Strength Bayer Plus Capsules, Cama Arthritis Pain Reliever, Arthritis Pain Formula, Alka-Seltzer with Aspirin, Phenaphen with Codeine, Aspirin with Codeine, Empirin with Codeine, Fiorinal with Codeine, Alor 5/500, Azdone, Damason P, Lortab ASA, Panasal 5/500, Synalgos -DC, Percodan, Percodan Demi, Oxycodone with Aspirin, Roxiprin, Propoxyphene HCl Compound, Darvon Compound 65, and many other brands. There are so many that they could not all be listed here. If you are taking warfarin (Coumadin, Jantoven) you should read the label of any pain relief medication to be sure that it does not contain aspirin. If you are unsure, purchase the product at a pharmacy where you can have the pharmacist check the label for you.

There is no general agreement over what constitutes an interaction between aspirin and warfarin (Coumadin, Jantoven). Some have theorized that aspirin makes the warfarin (Coumadin, Jantoven) more active. Lately, this theory has been downplayed. Some now say that there is no true interaction. They theorize that aspirin irritates the lining of the stomach and increases the likelihood of bleeding. If this gets started, the warfarin (Coumadin, Jantoven) will cause worse bleeding than aspirin alone.

If the theory of aspirin making warfarin (Coumadin, Jantoven) more active were true, then the effect of the aspirin could be measured with the INR test and the effect minimized. Unfortunately, the second theory seems to be true. In this case, the aspirin gives no warning, such as raising the INR. The bleeding just suddenly develops.

Some people have aspirin and warfarin (Coumadin, Jantoven) both prescribed. This is because they work on two different clotting factors. The combination can be very effective in preventing repeat heart attacks. When used this way, the dose of aspirin is very low and not likely to cause a bleeding problem. This seems to be safe for people who are at low to moderate risk for bleeding.

Unless prescribed by your physician, it is better to avoid aspirin. There are several alternatives such as acetaminophen, and celecoxib (Celebrex).

Reference:

Rothenberg et al. Ann Intern Med. 2005 Aug 16;143(4):241-50.

For a discussion of why warfarin (Coumadin, Jantoven) is prescribed as opposed to aspirin, click on WHY DO I HAVE TO TAKE WARFARIN WHEN SOMEONE ELSE TAKES ASPIRIN FOR A BLOOD THINNER?

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Last modified June 14, 2007