I Am Taking Anticoagulant ( Acitrom 4 Mg) Because I

Posted on Mon, 3 Feb 2020

Question: I am taking anticoagulant (Acitrom 4 mg) because I have had DVT thrice (2005, 2006 and 2013). As part of a fertility treatment that I am going through now I am advised to take the following, which, I believe affect the medication:
1) Pomegranate juice
2) Wheat Grass powder
3) Dry fruits /nuts - Raisins (15 pcs/day), almonds (7 pcs /day) and Walnuts (2 pcs/day)

I would like to know how these will affect my medication and what should I do?

Answered by Dr. Shailja Puri (1 hour later)

Brief Answer:
The food items mentioned are unlikely to affect INR

Detailed Answer:
Hello,
Thanks for posting your query on Healthcare magic.
The effectiveness of anti-coagulant is determined by parameter INR.
The INR should remain between 2 and 3.
If the INR goes outside this range then the dose of anticoagulant needs to be changed.
Warfarin and it's congeners like acitrom interfere with INR.
Food items rich in vitamin K interfere with INR.
These food items rich in vitamin K are green leafy vegetables, spinach, broccoli, asparagus, turnip, lettuce, pumpkin, cabbage etc.
The food items mentioned by you are unlikely to interfere with INR.

Thanks and take care
Dr Shailja Puri

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Shailja Puri (2 hours later)

Thank you, doctor. The reason I asked this is that I was told that food with vitamin K can affect the INR - so whenever I haev to eat something I look how much vitamin K it has. Athough I am not capable of understanding how much is too much, I just search to see and avoid if I see it mentioned somewhere as interacting with warfarin. I had done the same thing wtih wheat grass, walnut and pomegranate.

I forgot to mention that I am also prescribed a medicine Lyco Q and Selenium 100 . I hope this is safe as well.

In addition, I had been looking at some medicines that dont need INR monitoring like Pradaxa (which I saw has some XXXXXXX brands that are cheaper). Wouald you be able to comment on the benefits of this or whether it is better to stick to acitrom?

Answered by Dr. Shailja Puri (5 hours later)

Brief Answer:
Drug should only be replaced after consulting your doctor.

Detailed Answer:
Hello and welcome to HCM,
Acitrom is a suitable drug which should not be changed without consulting your treating doctor.
Foods items mentioned by you are unlikely to alter INR.
Only the vitamin K rich foods, some of which I have already mentioned should be avoided.
INR monitoring is essential with anti-coagulant acitrom.
Lyco Q and selenium are micro-nutrients and are safe to take with acitrom and food items mentioned.

Thanks and take care
Dr Shailja Puri

Above answer was peer-reviewed by : Dr. Raju A.T

Answered by Dr. Shailja Puri (11 hours later)

Brief Answer:
Acitrom has an easily available antidote so best to continue with acitrom.

Detailed Answer:
Hello and welcome again,
Your doctor is absolutely right that acitrom has a very easily available anti-dote if in any case bleeding happens.
Dabigatran is also a potent anti-coagulant approved by FDA used in cases of embolism, stroke, atrial fibrillation etc.
However, no anti-dote is available for dabigatran.
In addition, dabigatran is known to cause allergic reaction is some patients.
So, for now you can rely on acitrom.
If the INR is fluctuating, dose adjustment will help to correct the INR.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Shailja Puri (11 minutes later)

Thank you doctor for the affirmation about the food items/medicines.

Regarding change of Acitrom - I had already consulted a hematologist and he prescribed Dabigatran for me. I had visited him because another doctor (Physician at a Applo checkup clinic) had suggested I could consider it since y my INR at times fluctuate.

But I decided not to switch right now because the doctor mentioned that there is no antidote to it in case bleeding happens and needs to be reversed - like we have Vitamin K for acitrom. I did read online recently about some antidote to pradaxa (praxbind) - but I don't think it is available in XXXXXXX or at least not in all hospitals. So I wanted to know your opinion about the general idea of using pradaxa instead of acitro. I will definitely be consulting my doctor if I ever decide to change from acitrom as I am aware I should not do that without proper consultation.