Suggest Ideal Dosage Of Prednisone While On Coumadin

Posted on Wed, 26 Oct 2016

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Wed, 26 Oct 2016 Answered on

Wed, 16 Nov 2016 Last reviewed on

Question : I am on Plavix and Coumadin. I have home inr testing I need to take a short dose on prednisone for tendonitis that prevents me from working. I see that prednisine make Coumadin and Plavix more effective so how much should I cut back? I can follow the INR daily but I can't follow the platelet effect. and it would be good to have an idea of how to do this. The orthopod has no idea and the cardiologist is away and new to my case.

Answered by Dr. Indranil Ghosh (1 hour later)

Brief Answer:
Prednisone makes effect of coumadin less

Detailed Answer:
Hi
Thanks for your query. I understand your concern.

If you take Prednisone while on coumadin, the metabolism of coumadin is enhanced. So less active coumadin remains in the body and its efficacy reduces. So INR reduces.

So during Prednisone treatment, dose of coumadin should increase. Dose of plavix remains same.

If the duration of Prednisone is short, less than a week, better not to change anything. Because by the time the new dose is adjusted, it will be time to reduce it again. If for longer duration, increment by 10℅ at a time while checking INR every 3 days should do the job.

Hope this helps.
Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar