Can Coumadin cause side effects in my 91-year old mother?

Question

Hello doctor,

My mother is 91 years old. She is currently taking 4.5 mg (milligram) of Coumadin a day. She has developed a very itchy rash on most of her body. She has been on Coumadin for six years, but this dosage is particularly high for her. Her INRs (international normalised ratio) were only showing 1.2 to 1.4, which is why it was increased to 4.6 mg (milligram) from 3 mg (milligram) . Will this medicine cause this rash? She is miserable and we are currently putting Triamcinolone cream on the rash.

Coumadin was originally prescribed for atrial fibrillation, but she now has a pacemaker and did have an ablation. Is there any way to change her to Aspirin and discontinue Coumadin, which seems to be wreaking havoc with her system? I will be calling her primary doctor tomorrow; however, I want to have a little knowledge when I talk with him. Any of your comments will be appreciated.

Kindly advise.

Answer 1

Hi,

Welcome to icliniq.com.

I understand your concern.

Based on your query, my opinion is as follows:

No, as she was already on Coumadin (Warfarin) for a long time, it cannot be the cause of the rash. Aspirin and Coumadin have different methods of action, and one cannot be used in place of the other. Both may be used.

A preferred INR (international normalized ratio) is between two to three. Your mother's value is low, and thereby, a dose increase was necessary. She requires Coumadin, and Warfarin-induced rash is a very low possibility now. Coumadin (Warfarin) is not the case here.

Look for other environmental or food causes for allergy and itchy rashes. Antihistamines like Cetirizine can be taken for itching.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.