Question: Hi, my father had a CT guided needle biopsy done on Thursday 9/17. Tolerated the procedure without incident. He is on Coumadin and we stopped the Coumadin 5 days prior. He started with coughing up some blood tinged sputum on Friday evening. Went to Emergency room. No signs of Pulmonary Embolism. They said to go ahead and resume Coumadin. He is on a protocol with a Pharmacy at VA and the plan is to start him back on 7.5 mg the day after Biopsy which is Friday. He is at high risk for PE. He has had PE previous following a lung biopsy. Everytime he coughs he does have some blood noted in tissue but not a whole lot. His INR prior to procedure was 1.01. In ER on Saturday 9/19 it was 0.98. The Pharmacy plan is to start the Comadin which the ER doctor said to go ahead and the Pharmacy protocol is to start Lovenox 100 mg today which is Saturday. to bridge him. My concern is do I give him the Lovenox and the 7.5 mg of Coumadin so that he doesn't have complications of PE dispite his coughing of some blood. I won't be able to get a hold of his Pharmacist specialist until Monday and am trying to decide the best solution. Hold the Lovenox, hold the Coumadin, etc. His target INR is 2.0 - 3.0. His usual dose of Coumadin prior to all this is 5 mg M_W_F and 2.5 mg Tu,Th,Sa and Sun.
I would appreciate a suggestion so to prevent complications. thank you.

Thank you for your reply. He was not bleeding prior to his lung biopsy. Just after the procedure. He has been on Coumadin for years, but like I mentioned stopped 5 days ago. My father informed me it was just slight pink tinged now when he coughs.
I will ask his physicians if a filter would be helpful since we run into this problem everytime he stops his anticoagulant.

Thank you again for your time.