[otterdl]

Multiple myeloma, Coumadin, and INR levels

by otterdl on Wed Sep 19, 2012 9:49 pm

My husband was diagnosed with multiple myeloma in June of this year. He has been on Coumadin (warfarin) for 20 years and has not had much difficulty keeping a consistent INR. Since April, before he had a diagnosis, his INR has fluctuated wildly, ranging from 7.5 to 1.4. We have tracked it closely with all of the new drugs. He had his stem cell harvest last week and had a heparin bridge for the profusion catheter insertion. (He has a history of prolonged bleeding with Lovenox [enoxaparin]). Now we are back in the hospital for heparin due to INR 1.4, despite increased dose of Coumadin.

Does multiple myeloma affect Coumadin and/or INR levels?

Thanks.

[Norm]

Re: Multiple myeloma, Coumadin, and INR levels

by Norm on Thu Sep 20, 2012 1:14 pm

I, too, have been on Coumadin for about 20 years, was diagnosed with multiple myeloma in September 2010 and had a stem cell transplant in March 2011. Lovenox was used as a bridge for the tube insert and has not been a problem for me. When going back on Coumadin, it took some adjustments to get it back up to the proper level, but I never had the wild spike that you had.

One thing that I found was that my diet had changed following the stem cell transplant, which probably affected the INR. I wasn't eating as much food and likely changed the types of food a little. My diet is mostly back to normal now, but I still avoid all fried food, lettuce, or too many fresh fruits and vegetables, as they can cause diarrhea with the Revlimid that I take. I also take a multivitamin now, which made a difference in the INR. My INR is now steady, but I need more Coumadin to maintain the same INR level.

I don't know if any of this helps you, but your body, your diet, your activity level and the drugs you take are all going through changes that can impact the INR. I don't know if the multiple myeloma impacted the INR. Eventually all of this will likely settle down.

Good luck with this!