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Does Hydroxycarbamide & Warfarin offer double safety from clots?

Posted , 3 users are following.

mark75883
mark75883

Like many, I'm on both for life for my Polycythemia. As Warfarin can be unstable at times, especially when I'm I'll, I just wondered if I'm correct in thinking that even though my INR may drop below the theraputic range I should be ok from clots because Hydroxycarbamide reducedsthe red & Platelet counts in my bone marrow as well.

When I've had an upset stomach my INR seems to shoot up so they get me to stop taking Warfarin for a couple of days but it can then drop quite a way.I get anxious if my INR gets too low.

Regards

Mark

0 likes, 16 replies

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  • nandrews
    nandrews mark75883

    Posted

    Mark,

    I believe you are right I am on both and I think for that same reason.

    I had a liver transplant resulting from a blood clot in '92. My liver consultant told me, emphatically, never to stop taking warfarin.

    Before a hernia op a couple of years afterwards, the local doctor said to "just stop taking warfarin a few days before the op". That was swiftly countered when I checked with my consultant and I was instead put on heparin for the days before the op.

    So I think both are important - "belt and braces".

    Nigel

  • james03855
    james03855 mark75883

    Posted

    No I don't believe that is right as the warfarin is for thinning the blood. In my own case my consultant decided to put me on aspirin in place of the warfarin and within one week I had DVT again. I was put on self injection heparin for 10 days and back on warfarin. I understand that there is a new drug out that might suit you as you don't need to have INR checked. Hope this helps. 
    • mark75883
      mark75883 james03855

      Posted

      Hi James, 

      Are you on Hydroxycarbamide as well?

      My INR was 5.5 so they stopped it for two days.

    • james03855
      james03855 mark75883

      Posted

      Thanks Mark. Yes I'm on the same meds as yourselfI get the check on it every 2 weeks or if put on something new every week. As I said as soon as I came off the warfarin I had clot again I was still on the Hydrourea and had vena section done. That's why I think that warfarin is necessary for me the aspirin did not work. I hope that helps
    • mark75883
      mark75883 james03855

      Posted

      Hi James,

      How long did you stop warfarin for before the clots developed? I've had to stop taking it for two days in the past but my INR was 7! If you don't mind me asking what was your INR when you stopped?

      Apparently an INR above 5 can be dangerous. Yesterday my INR came back as 5.5 and I was told to stop taking it last night and tonight. I'm currently on 7.5 mg per day. With regards to Hydroxycarbamide I take 500 mg daily. All my blood counts are within range.

      I'm very confused now and slightly woriied as one of the main attributes of Hydroxycarbamide is to control clots as it lowers the platelet count. As per the UK leaflet below. 

      http://www.mpdvoice.org.uk/wp-content/uploads/2011/04/MPDVoice_Hydroxycarbamide_A4.pdf

      Regards

      Mark

    • mark75883
      mark75883 james03855

      Posted

      Hi James,

      What was your INR when you stopped warfarin and how many days had you stopped before the blood clots returned?

      In the past I've stopped for two days when it was 7 and yesterday my INR was 5.5 so I've had to stop last night and tonight.

      According to MPD Voice one of their leaflets says "Hydroxycarbamide can control your blood counts, and this can reduce the risk of both blood clots and bleeding."

      I'm confused about all this and starting to get a bit worried.

      Regards

      Mark

    • james03855
      james03855 mark75883

      Posted

      Mark my INR was 2.0 and the consultant thought that as pro might be able to control the clotting. I off warfarin from Mon and clot returned on Fri so approx 4 days. I had been on the warfarin for approx 6 mths. Also when I had colonoscopy I was not taken off the warfarin as they were not going to do any biopsies
    • mark75883
      mark75883 james03855

      Posted

      Hi James,

      Seems strange that your blood should clot when Hydroxycarbamide wil have brought all your blood counts into a normal safe level, especially your platelet count. That's what confuses me about all this. If Hydrourea does its job then surely it makes your blood normal.  

    • nandrews
      nandrews mark75883

      Posted

      Mark

      I throw this in for what it's worth.

      Could it be that James's INR is elevated beyond that controllable completely by Hydrea. So they add suitable Warfarin to just bring the INR down. If they upped the Hydrea dose more, then it would bring other levels down too much!

      Nigel

    • mark75883
      mark75883 nandrews

      Posted

      Hi Nigel,

      I'm on 500 mg of Hydroxycarbamide here in the UK. Is that the same dose they administer elsewhere?

      Regards

      Mark 

    • mark75883
      mark75883 nandrews

      Posted

      Hi Nigel, 

      Could it be that James's INR is elevated beyond that controllable completely by Hydrea. So they add suitable Warfarin to just bring the INR down. If they upped the Hydrea dose more, then it would bring other levels down too much!

      I don't fully understand what you mean.

      Regards

      Mark

    • james03855
      james03855 mark75883

      Posted

      Hi Mark

      I was diagnosed 3 1/2 years ago 500mgs hydro urea and 5 mg one day 4mg next INR 2.5

      In May this year I take hydro urea for 5 days then skip 2 days

      Nigel may be right about blood and platelet levels but when I clotted on the aspirin I had to self inject with innohep.

      Regards

      Jimmy

    • nandrews
      nandrews mark75883

      Posted

      OK assuming that a dose of Hydrea reduces all the bloods levels inc. INR

      You were asking why James needed Warfarin aswell.

      But if the INR is still too high, they could not increase the Hydrea dose to reduce it because that would reduce the other levels below optimum.

      So I suggested that was the reason for warfarin which is to just get the INR to the right level.

      Nigel

    • mark75883
      mark75883 nandrews

      Posted

      Hi Nigel,

      I now understand what you mean. Many thanks for the explanation.

      I just need to now understand why a normal platelet and red blood cell count (As controlled by Hydrea alone) might still lead to blood clots!

    • nandrews
      nandrews mark75883

      Posted

      I missed this one as it went to Spam.

      I am on 1gm (with 1.5 at weekends)

      Nigel

      I am also in UK

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