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Q. As Coumadin causes skin rash, shall we switch to Aspirin?

Answered by
Dr. Prakash H Muddegowda
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Sep 26, 2016 and last reviewed on: Sep 09, 2019

Hi doctor,

My mother is 91 years old. She is currently taking 4.5 mg 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 were only showing 1.2 to 1.4, which is why it was increased to 4.6 mg from 3 mg. 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 fib, 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. Thank you.

Dr. Prakash H Muddegowda

Dr. Prakash H Muddegowda

Geriatrics Hematology Pathology
#

Hi,

Welcome to icliniq.com.

Based on your query, my opinion is as follows:

  • No, as she was already on Coumadin (Warfarin) since 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 another. Both may be used.
  • A preferable INR (international normalized ratio) is between 2 to 3. Your mother's value is really low and thereby dose increase was necessary.
  • She definitely requires Coumadin and Warfarin-induced rash is a very low possibility now. Coumadin (Warfarin) is not the cause here.
  • Look for other environmental or food causes for allergy itchy rashes. Antihistamines like Cetirizine can be taken for itching.

For further information consult a geriatrician online --> https://www.icliniq.com/ask-a-doctor-online/geriatrician

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