Q: Does Extra-Strength Tylenol interfere with Coumadin?

My mom is on Coumadin 3mgs daily. Her INR test today was 1.8., and her doctor wants it to be 2.5. Can extra strength tylenol interfere with this? She takes it 2x daily for aching feet at night. The doctor increased this Coumadin last week from 1.5 mg to 3mg. What makes her blood drop like this? She's not eating any thing she's not supposed to.

Q: Dr. Gourmet Says...

It is very possible that your mother's Tylenol® use is an issue for her. Physicians generally recommend using acetaminophen because of a decrease in the risk of bleeding when compared to other pain relievers. However, it is possible that Tylenol can have an effect on the INR.

The best plan is to review all of the medications that your mother is taking with her doctor. Take all of the bottles (full, empty, new prescriptions, old prescriptions and over the counter medications) with you to her visit. Her doctor can help you come up with a plan for consistent use of medications that will help control her pain and keep the INR stable.

Keep in mind that there are a lot of foods that contain Vitamin K and can have an effect on INR levels. A good example is parsley. A tablespoon has about 60 micrograms of Vitamin K. This higher amount in a such a small amount of parsley can be an issue because parsley is found in a wide variety of foods.

Here are links to lists of ingredients and their amounts of Vitamin K. There are both simple and comprehensive lists of ingredients that are used in Dr. Gourmet recipes that may help guide you.

http://www.drgourmet.com/md/warfarinbrief.pdf

http://www.drgourmet.com/md/relativewarfarinlist.pdf

http://www.drgourmet.com/md/warfarincomprehensive.pdf

Thanks for writing,

Dr. Gourmet