Q. I was very upset to read your response to a question about the blood thinner Coumadin. You listed several drugs that may interact with Coumadin; one of them was Tylenol.
I am a heart valve patient. My cardiologist is one of the most respected doctors in the country. He told me never to take any drug without clearing it with him first.
The one drug I am allowed to take without asking a doctor is Tylenol. After I read your column I became alarmed. I spoke to two cardiologists, an infectious disease doctor, a neurologist, an ophthalmologist, and two pharmacists. ALL said Tylenol was not incompatible with Coumadin.
You should do more research before responding to such inquiries. Please print a correction.
A. We are sorry we alarmed you. Most physicians realize that aspirin and other anti-inflammatory drugs can cause problems in combination with Coumadin. Despite research going back 30 years, few are aware that acetaminophen (Aspirin Free Anacin, Panadol, Tylenol) can also interact with this anticoagulant.
Although it is safe for a patient on Coumadin to take Tylenol occasionally for a headache, regular use (more than a few days) could increase the risk of hemorrhage.
A study published in the Journal of the American Medical Association (March 4, 1998) showed that people who take fewer than three doses (six 325 mg tablets) per week have little to worry about, but just four tablets a day for a week result in 10 times the danger of bleeding. More recent studies in the European Journal of Clinical Pharmacology (March, 2011) and Pharmacotherapy (June, 2011) confirms this link in some patients.
Anyone taking Coumadin should be aware of all potential incompatibilities. We’re sending you our FREE Guides to Food, Drug and Coumadin Interactions which describe many of these problems in greater detail.
