I am taking Coumadin, why does my protime / INR fluctuate so much?
Many factors can affect the absorption and utilization of Coumadin. The use of alcohol and many antibiotics make Coumadin stronger. Steroids, some narcotic painkillers, cholesterol medicines, arthritis medication and larger doses of Tylenol can also make it stronger. Having any illness can affect the level, particularly having diarrhea. Travel to climates different from your home can affect it. Vitamins C and E, herbal supplements like gingko and fish oil tablets have an effect. Chemotherapy and radiation therapy affects absorption in your gut, which can affect your level. Foods rich in vitamin K counteract the effect of Coumadin. These include leafy green vegetables, green tea and mayonnaise. Eating a diet that is consistent in the amount of vitamin K rich foods will help to maintain a stable level. Please notify the Coumadin Clinic should you have any changes in medications or diet that may affect your Coumadin.
