Patient is elderly and has just been prescribed a new medication. The patient also has history of arthritis so she is going to the pharmacist to buy her usual NSAID pain relief, Advil, but wants to know if she can still take it with her new medication. Student is able to understand interactions of OTC pain relievers with prescription medications.
Explain to tell patient that NSAIDs interfere with warfarin (Coumadin) and that acetaminophen is the preferred option for pain relief but should still be careful not to use in excess. NSAIDs or aspirin increase a patient’s risk for serious bleeding while you are on anticoagulant therapy (taking Coumadin).
The maximum dosing for OTC acetaminophen in normal patients is 3000 mg. A patient taking warfarin should try and aim to not exceed 2000 mg a day until INR is stable and full effects are realized. Make sure they continue to see their primary healthcare provider to check their INR (International Normalized Ratio) to make sure that taking acetaminophen isn’t interfering with their anticoagulation therapy.
The patient should also be counseled in potential non-pharamcologic treatments for their arthritis such as physical therapy and occupational therapy to help improve their daily activities.
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