Drink Wine?

[temp69]

My cardiologist said it was okay to drink wine with coumadin. Anyone out there with a valve replaced (either mechanical or tissue) who still enjoys wine? Would LOVE to hear from you. Not currently drinking anything, but looking forward to drinking some nice pinot after the surgery.:)

[Natanni]

My husband has wine or beer 2-3 times per week, sometimes a little more and sometimes a little less. The most he has had at one time was 4 beers over a long afternoon banquet. You will find that there are alot of coumadin users here who do have alcoholic beverages in moderation and *consistancy*. Nathan has been consistant in that he usually does drink some form or another 2-3 times per week. It varies more on how much, but he is still sort of new to anticoagulation so he is still testing the waters a bit. He does home monitor his INR, and has checked it before, during and after and so far what he has done has not changed his altered his INR yet.

[temp69]

[QUOTE=temp69]My cardiologist said it was okay to drink wine with coumadin. Anyone out there with a valve replaced (either mechanical or tissue) who still enjoys wine? Would LOVE to hear from you. Not currently drinking anything, but looking forward to drinking some nice pinot after the surgery.:)["Every breath is a gift...unless you're downwind of my beagle, Tucker."]

[Magnus]

When I hit the town I usually have 5-6 beers in an evening. I tend to avoid drinking until I'm slouched over the toilet nowadays, but then again I'm only 7 months post-op, so maybe give it a while...

[geebee]

I have a drink about once a week. It is usually a mimosa with brunch or a Bailey's after a tough day. Once in awhile we go out to eat and then I will have some saki or champagne. I rarely have more than 2 of any drink and usually only one but that is because I am very sensitive to alcohol (read - cheap drunk here).;) :D ;)

[JimL]

We did a winery tour this past Wednesday (Coloma, MI), and bought four bottles. Now, the bottles look very nice, and no date is planned to open them, but they will be opened eventually.
When I make a reunion again, I have three bottles of homemade wine labeled for VRcom, and they will come along.

[Georgia]

My cardio said he recommended a 4 oz. glass of red wine daily. He also said that if you're going to drink at all on coumadin, then drink the same amount daily. This was about a 1000% increase in alcohol consumption for me, but I do have a drink every day. Usually wine; occasionally replaced by a cocktail, Bailey's or beer.

[Ross]

There is nothing wrong with a drink now and then while on Coumadin. The problem arises if you have or are predisposed to ulcers. The alcohol can irritate the stomach until it bleeds and if you get a bleed going in there while on Coumadin, it may be your life.

[tommy]

Occassionally I'll drink some wine. Limit 2. Never within three days of an INR test.

[catwoman]

I occasionally drink some wine.
Last weekend, I had several margaritas. Was at a cat show in Grapevine, Texas, (a town that touts wines, by the way), and a Mexican restaurant (Los Lupes) catered the show, instead of forcing us to have the usual crappy concession stand hotdogs, etc.
Food was great, but even better were the MARGARITAS!!!!!!!!!!!!!!!! Wonderful frozen margaritas for $2.75 (a bargain!). I had one Saturday, 2 on Sunday. The first one I got Sunday spilled (no, I was not tipsy), so I got a
2nd one.

This weekend, the cat show is in Tulsa, Oklahoma. Only beer served at the convention center. :-((((

I usually only have a small (4 ounces) glass of wine or small martini or margarita when I do drink. Too many empty calories otherwise; I also don't want to get tipsy and slip, hit my head. (Years and years ago, I would have with several!)

[Christine]

ah, Marsha.. how do I miss margaritas since leaving Dallas.. not crazy on making them as I have a old blender..and no room in the freezer for a bucket, and haven't found a decent place up here... how is the metroplex doing anyway?? been several years and I do miss it at times.. went on line recently to see the High 5 project.. I left in the middle of that.. what can i say, only in texas..

on to the topic - I too drink.. not as much as I used to.. but i'll split a six now and then with someone.. enjoy my White Merlot as well (not on same day of course).. I don't drink everyday, but 2-3 (4 in rare cases) per sitting - once or twice a week.. in the begining, I used to be nervous and "count" my servings.. don't anymore.. I've learned to be intune with my body and know what it can and cannot handle.. plus home testing helps keep me in control as well.

be safe and enjoy the day

Chris

[Alaska]

Does alcohol raise or lower INR? Or, does it vary person to person?

[EVELYN]

Hi Temp69

My husband, AVR 6/02 has a glass of wine each and every night. He enjoys it and never has more than one.....our cardio said he'd much rather he have one glass a day, than have 2 or 3 on the weekends, so that is what he does.

NOOOOO problem with his INR.

Remember the rule: dose the diet.....or something like that.

Enjoy it.

Evelyn

[Kate]

I don't know much about this, not having a mechanical valve, but I think Ross raises a very good point. My understanding is that the risk of drinking alcohol with Coumadin is a whole other issue than, say, eating a big spinach salad. It isn't so much that it will change the INR (although for all I know it may do that as well) as that it can result in serious stomach bleeding. If that is the case, I wouldn't think that consistancy or home testing would make any difference. Instead, I would think the key would be making sure that one is periodically screened for ulcers (is there some relatively painless and inexpensive screen for this? )

If someone else knows more about this and I've gotten it wrong, please let me know. This is a question I've wondered about alot (liking a few beers myself :) ) and would really appreciate additional clarification. Thanks, Kate

[sue943]

It took me about six months to pluck up the courage to have a drink, I wasn't a heavy drinker prior to surgery, nor am I now. I might have a 25cl bottle of lager or a glass of wine or cider. Might be several days running, or could be weeks apart. I haven't had any problems, yet.

[geebee]

I don't know much about this, not having a mechanical valve, but I think Ross raises a very good point. My understanding is that the risk of drinking alcohol with Coumadin is a whole other issue than, say, eating a big spinach salad. It isn't so much that it will change the INR (although for all I know it may do that as well) as that it can result in serious stomach bleeding. If that is the case, I wouldn't think that consistancy or home testing would make any difference. Instead, I would think the key would be making sure that one is periodically screened for ulcers (is there some relatively painless and inexpensive screen for this? )

If someone else knows more about this and I've gotten it wrong, please let me know. This is a question I've wondered about alot (liking a few beers myself :) ) and would really appreciate additional clarification. Thanks, Kate
Kate,
I have been on coumadin for over 25 years and have never changed what I eat or drink. Never had a cardio tell me drinking was a problem. Maybe it is if someone is predisposed to stomach bleeding but I do not think coumadin and alcohol will cause it unless someone really does binge drinking and then they would have more issues than just coumadin.

[Natanni]

Actually Kate, I do think that alcohol comsumption does affect a person's INR. While Nathan has not seen it happen personally yet (and home testing was a help with this as he was able to test many times when his clinic was not open, we would not have known that he personally has not had an effect from this otherwise) I know people that have seen fluctuations with even 2 drinks. Did Al say that it has to do with metabolism of the liver?

The ulcerative condition can not be ignored (my Dad died as a result of a GI bleed, and he drank vodka...straight), and Nathan's cardio I think would prefer NO alcholol at all due to effects on the heart. This is another issue altogether. Now if Nathan liked red wine :) it sure would be better than beer, hehehe. But alas, he wants to live out his life enjoying it to the fullest, and that means feeling normal enough to have a couple with his buddies now and then :)

[DrAllan]

Goggle is amazing at finding information. Unfortunately separating the wheat from the chaff can be difficult, especially for a layperson. I am copying an excellent response regarding alcohol and INR. Note that it is dated 4.24.06

76. Alcohol and warfarin (coumadin®)
Last Updated: 4/24/06

Q: “Does alcohol intake increase the INR?”
A. I am not aware of any study that has looked in detail at the influence of alcohol intake on the INR in patients on warfarin (coumadin®).

I am aware of only 2 studies that somehow address the issue of alcohol and INR (references 1 and 2). Both studies showed that individuals who drink alcohol are not more likely going to be over-anticoagulated, i.e. have INRs above 6.0, than individuals who do not drink. In one of the 2 studies (reference 1) this was true even for individuals who drink heavily. However, these studies did not address the question whether alcohol intake actually has an influence on the INR values. The interaction between alcohol consumption and warfarin therapy is said to be complex. A review article (reference 3) concluded:
0. Intermediate use (2-3 drinks per day) probably does not alter the INR at all.
0. Intermittent large amount of alcohol drinking leads to an increase in INR, because the alcohol interferes with warfarin metabolism, i.e. warfarin is metabolized less rapidly.
0. Chronic heavy alcohol intake results in a decreased INR, because the alcohol actually increases the metabolism of warfarin.

Personal comment:
I typically tell patients on warfarin (coumadin®) who drink mild to moderate amounts of alcohol (1-2 glasses of wine or 1-2 beers per day), that such alcohol intake is likely o.k. from a clotting and bleeding point of view.

References
0. Penning-van Beest FJA et al: "Lifestyle and diet as risk factors for overanticoagulation". J Clin Epidemiol 2002;55:411-417.
0. Hylek EM et al: "Acetaminophen and other risk factors for excessive warfarin anticoagulation. JAMA 1998;279:657-662.
Buckley NA et al: "Drug interactions with warfarin". Med J Aust 1992;157:479-83.

[allodwick]

I agree with Dr. Allan. I have read the articles and discussed the second article with Eliane Hylek. Unfortunately much of what she said has been widely misquoted in the lay press and reported on the internet. She was so unhappy about how the press distorted the article that she told me, "This red-headed Pollock will never give a videotaped interview again."

[mtkayak]

I don't drink everyday but when I drink I tend to drink alot. I would say maybe twice a month I drink. Whether it's camping with friends or going to a party. I'm 11 weeks Post Op and I've drank twice pretty heavily but have had no problems. In fact, the weekends that I drank my INR was perfect. Go figure!!! My range is 3.0 - 3.5 and I was dead on at 3.3 both times. My Cardio preaches "consistency". "It is okay to have your happy time as long as you remain consistant with it." Unfortunately, drinking is one thing I'm not consistent with. No problems yet though.

[allodwick]

You might picture binge drinking as a set of steps. Nobody knows how many steps there are to the door the represents a GI bleed. The INR doesn't count the steps. It is unlikely that there are only 2 steps. More like 30 or 40. One day you will almost certainly open the door. The false sense of security from "nothing happened so far" is one of the major dangers.

[mtkayak]

I've drank like that all my life and had no problems. In fact, I've gone months without picking up a beer. Binge drinking is something that just happens not something I plan. The older I get the less frequently it occurs. I understand the danger and am aware of it. On the other hand, I like to live my life without fear and complete restrictions. Having said that, I do all else in respect to my condition ( exercise daily, eat healthy and routine check ups and physicals).

[Ross]

Actually Kate, I do think that alcohol comsumption does affect a person's INR. While Nathan has not seen it happen personally yet (and home testing was a help with this as he was able to test many times when his clinic was not open, we would not have known that he personally has not had an effect from this otherwise) I know people that have seen fluctuations with even 2 drinks.

Natanni not to pick on you, but these other people, did they test before drinking and after drinking and come up with a .2 or whatever variation? Tell them not to drink and do the samething, they'll see the same results. It's just the nature of INR.

[geebee]

You might picture binge drinking as a set of steps. Nobody knows how many steps there are to the door the represents a GI bleed. The INR doesn't count the steps. It is unlikely that there are only 2 steps. More like 30 or 40. One day you will almost certainly open the door. The false sense of security from "nothing happened so far" is one of the major dangers.
Al,
Are you saying drinking at all is dangerous or drinking a lot is dangerous?

[LadyBlue]

Oh dear...I love a good sip of wine daily. I don't get drunk, or party heavy, but I do like to tip the grape when I can. ;) I think once I do get confirmation when I will have my valve replacement, I will go totally holistic and give up all the wine, junk food, and salt. Water and Macrobiotics! ...oh JOY! :D

[geebee]

Oh dear...I love a good sip of wine daily. I don't get drunk, or party heavy, but I do like to tip the grape when I can. ;) I think once I do get confirmation when I will have my valve replacement, I will go totally holistic and give up all the wine, junk food, and salt. Water and Macrobiotics! ...oh JOY! :D
Then just why are you having the surgery???????;) :D ;)

[LadyBlue]

Then just why are you having the surgery???????;) :D ;)
hahaha TRUE! :D

[MarkU]

I have a couple of glasses of red wine with dinner 3 to 4 nights per week. I wouldn't consider myself to be a binge drinker, but on weekends or at social gatherings I may have up to four to five glasses over the course of an evening.

Discussed drinking with both my surgeon and cardiologist after my surgery - neither had any problems with it. Their only advice (which also applied to my diet) was to be consistent with whatever I did.

In 5-1/2 years, I've never seen any correlation between my INR level and my alchohol comsumption.

What I have seen is a very noticeable affect on my INR related to my activity level - if I singificantly increase or decrease my workout volume.

[Kate]

I'm still confused. When you go the the Coumadin website, they very clearly recommend that alcohol not be consumed while on their medication, yet many people on this site have obviously been told by various doctors that drinking in moderation or the same amount every day is okay. The scientific study referenced seems to focus on alcohol's impact (or lack of impact) on INR, but that seems to miss the point of the real danger, which is stomach bleeding. Even Al, our fabulous Coumadin expert, seems uncertain - suggesting that some drinking is probably okay but cautioning that how much is "too much" is difficult to predict and that there are no warning signs when one is getting close to a serious bleeding situation.

Is it reasonable to assume that the risks associated with drinking on Coumadin are serious but rare, so that most people can safely drink in moderation but that some very small portion will end up with life-threatening complications? If this is the situation, is there some way to determine who is most at risk? I hate to belabor this, but it seems like an important issue that we just don't know enough about. Kate

[geebee]

Kate,
My guess is that if a person has issues with stomach bleeding without being on coumadin (whether due to alcohol or other things), then being on coumadin could make drinking more dangerous. I do not think coumadin and alcohol will CAUSE stomach bleeding in those who drink lightly. As I mentioned in my earlier post, I have been on coumadin for over 25 years, drink lightly and have no signs of stomach bleeding. Apparently that is the case for many of us.

[Sherry]

I've been on coumadin for nine years and enjoy a small glass of wine or two an evening with no problems. (In fact, I've enjoyed some wine with the previous poster on a Chicago trip once.) However, something that I've learned is not to buy those big wine glasses that are so popular now. The glasses I drink out of are small and hold 5 oz. tops, which is the recommended daily allowance anyway. The key here is moderation.

[Jimmy]

Hi everyone, here's a question for everybody (especially AL Lodwick) I usally take 5 mg every day (35)mg a week last week I went up to 6.1 so I skipped one dose and went back to my 5 mg a day for the rest of the week...tested the next week and I was 7.6 on Monday (29th May) well will miracles never cease...my "Dr." called and he wants me to skip one dose then take half my dose (2.5mg) the rest of the week and retest on Fri (June 2nd)...I think that it's far to much of a change and I told him so. What I did was skip one dose and took two 1/2 doses (2.50 mg) but I'm not sure what to do the rest of the week....I was thinking that I'll take 3.5mg for the next two days (Thurs. and Fri.) because if I test on Fri. I don't get my results back till Sat. AM What does everbody think ?....I really need help on this one.

St.Judes mechanical Aortic valve
Quad CABG
Thanks, Jimmy..................BTW I also have a few beer every day and my cardioligist said it should not effect my INR as long as I was consistant.

[geebee]

Jimmy,
I think holding one dose was the right thing to do. I would also take a half dose the day after holding. You should then decrease your weekly dose by 20% and then retest in one week. Based on where you are then you can then adjust or keep on the reduced dose.
Since you take 35mg/week, you should reduce by 7mg. You should take 4mg/day or some variation thereof depending on the pills you have.

Do you have any thoughts on what has changed to cause your INR to rise?

[Jimmy]

No idea Gina, I drink anywhere from 4 to 5 beer every day and my INR can go from 1.8 to 8.1. I try to be consistant with my vit. K intake but it's hard sometimes and for as much as I might vary my "greens" I can't see that making that much of a differance. I wonder if stress could play a big part in this roller coaster ride ?
Jimmy

[geebee]

I guess there is a possibility that the high end results are test problems and not "real" results. Are those fairly frequent or exception?
You might want to try and keep a diary of what you do and eat over a few weeks (do NOT alter what you normally do or eat) to try and identify trends.

[Karlynn]

I've been on Coumadin for over 14 years. I love red wine, Cosmopolitans, and Morgans w/ Coke. I've never seen my INR flucuate due to alcohol. I'll have a total of probably 4 or 5 drinks a week. I won't mention my recent trip with the girlfriends to Florida and our love of Cosmos.:o My INR upon my return was slightly high, but my INR always starts to go high w/ travel. I'm not going to stop traveling because my INR goes up.

[allodwick]

Macrobiotics pose a problem with warfarin. The bacteria produce vitamin K. This will cause a need for an increased warfarin dose and potentially high INRs if you do not consume the same amount of bacteria consistently.

Two of the main things you need to learn about warfarin are that advertising does not apply to you and much of the information in "health food" books works against warfarin.

[Valve-Viking]

I guess if everybody just followed the doctor´s advice of 1-2 drinks
per drinking occasion, the INR would be fine, there would not be any
risk of a GI bleeding.

I think that some people asking about alcohol and coumadine are trying
to find some proof that it would be o.k to drink more or to find some in
the medical field that would o.k it.......but in the end I think it is up to
yourself to decide whether it is worth the risks. As Al said, you never know
when you might have an GI bleeding, only thing is that the risk increases
with age and with excessive(now againwhat is excessive??) drinking.

Here in Sweden, the doctor´s say, "drink in moderation". It´s like saying
"eat in moderation", what might be a big meal for someone, might be an
appertizer for another person! But the professional point of wiew is of
course you should limit it too 1-2 drinks - discussion ends there.

Then for myself, I sometimes drink more, but not binge. I also try to avoid
any hard liquor as I think it tends irritate your stomach more?

I can see an elevated INR after drinking a bit more then the 1-2 glasses
for some days in a row, like on a holiday, but nothing above 4.0 normally
(worst case scenario!).

Cheers!!?

Martin

[mtkayak]

I think the old saying "Everything in moderation" is the mantra for anybody not just for valvers. Unfortunately, in life there is temptations that somtimes lead to excessive. Everybody is different, what one person metabolism rate is isn't the same for others. I think you can generalize all day long but it still wouldn't apply to everybody. I know myself and what my body can handle. I know when to stop 95% of the time. I'm not a gambler but I'm an odds maker. If I'm good 95% of the time, then I like my chances. Again, I refuse to live my life in fear. Comadin will not rule my life. It keeps me alive (so to speak) and I respect that.;)

[allodwick]

Mike,
I think that you have the best attitude. You are aware of warfarin and consider what might happen but you do not allow it to the the overridingforce in your life. Every moment we are all weighing the risks vs benefits of what we are going to do next in everything we do. Warfarin is just one more factor.

[Valve-Viking]

I entirely agree with Mike too an it is also why it is so hard to make
any general recommendations. I am a big tall guy(Viking you know!)
and I probably hardly feel the effect of 2 drinks, where somebodyelse
petite might be a bit tipsy!

So find your own comfort-zone, relax & enjoy!

/
Martin

[LadyBlue]

Macrobiotics pose a problem with warfarin. The bacteria produce vitamin K. This will cause a need for an increased warfarin dose and potentially high INRs if you do not consume the same amount of bacteria consistently.


Allodwick,

nahhhh...I'm not a macrobiotic purist in any sense of the word, but my version of it just means going organic, and eating lots of whole foods and not processed foods. Lots of rice and beans, fresh veggies, fruit, low sugar and salt. Nothing too extreme. I'm a vegetarian as well, so eating like that is not a problem for me. :D

LB

[geebee]

Allodwick,

nahhhh...I'm not a macrobiotic purist in any sense of the word, but my version of it just means going organic, and eating lots of whole foods and not processed foods. Lots of rice and beans, fresh veggies, fruit, low sugar and salt. Nothing too extreme. I'm a vegetarian as well, so eating like that is not a problem for me. :D

LB
I ate just about everything organic when I lived in California because of a great store called "Whole Foods". We do not have much organic foods worth eating here in Ohio. There are some and I eat organic whenever I can. I am allergic to many processed foods so I have to be really careful.
I sure miss my mostly organic foods.

[LadyBlue]

I ate just about everything organic when I lived in California because of a great store called "Whole Foods". We do not have much organic foods worth eating here in Ohio. There are some and I eat organic whenever I can. I am allergic to many processed foods so I have to be really careful.
I sure miss my mostly organic foods.

I hear you. Whole Foods ( the market) was kind of "born" in the Boston area from a small, hippy chain called Bread & Circus in Cambridge. I am so glad to have access to them, they are great for healthy eating for sure! Where in Ohio are you? Whole Foods is on the march so go on thier website and see if there may be one put up in your area anytime soon! Also, there are other chains popping up based on organic/healthy foods. You should eat the best you can! :D

[DrAllan]

Hi All,

Completely off the subject of Warfarin, but I cannot resist commenting on “Whole Foods”. I am in the process of moving and one of the real estate considerations is the proximity to a Whole Foods. I rather like the romantic story of WF arising from the original “Bread & Circus”, however that is not the truth. Whole Foods Market (WFM) which was formed in 1980 acquired B&C (which itself was opened in 1975 was acquired by WFM in 1992. To read the entire history, go to http://www.wholefoodsmarket.com/company/history.html

[geebee]

I hear you. Whole Foods ( the market) was kind of "born" in the Boston area from a small, hippy chain called Bread & Circus in Cambridge. I am so glad to have access to them, they are great for healthy eating for sure! Where in Ohio are you? Whole Foods is on the march so go on thier website and see if there may be one put up in your area anytime soon! Also, there are other chains popping up based on organic/healthy foods. You should eat the best you can! :D
Sorry to be off topic also (unless you consider that Whole Foods has great wines);) :D ;) . The only store in Ohio is in Columbus which is about 100 miles north of me. Might be worth the trip in good weather but, otherwise, a bit far.
I am still hopeful tho.

[allodwick]

In Colorado neither WF nor any other grocery store can sell wine.

[LadyBlue]

Hi All,

Completely off the subject of Warfarin, but I cannot resist commenting on “Whole Foods”. I am in the process of moving and one of the real estate considerations is the proximity to a Whole Foods. I rather like the romantic story of WF arising from the original “Bread & Circus”, however that is not the truth. Whole Foods Market (WFM) which was formed in 1980 acquired B&C (which itself was opened in 1975 was acquired by WFM in 1992. To read the entire history, go to http://www.wholefoodsmarket.com/company/history.html

Ahhhhh ok....so I crossed my wires a bit...:o ..I'm not totally wrong tho. WFM bought out B&E, a small hippy chain and thus giving way to the birth to the presence of WFM!! :D

I do like your criteria for a WFM in the vicinity of where you move too. I would do the same ( after all, I was raised on Bread & Circus in Brookline, Mass!:D )

History of Bread & Circus
Anthony and Susan Harnett purchased the first Bread & Circus store in Brookline, Massachusetts in 1975. The first Bread & Circus sold natural foods and wooden toys, hence the unusual name.

New stores opened in Cambridge (1979) and Wellesley (1980). In 1983, Bread & Circus challenged itself by expanding into Hadley, Massachusetts, located 100 miles from the Boston home base. In 1988, the company opened a store in Newton, MA. Later that year, it moved its central office to Newton, and established a central Commissary there. The Providence, Rhode Island store opened in 1990, and the original Brookline store moved to Brighton, Massachusetts in 1991.

At the time of its acquisition by Whole Foods Market in 1992, Bread & Circus was the largest natural food retailer in the Northeast.

[ClickerTicker]

I do enjoy wine most days, normally not more than half a bottle. I've noticed no effects on my INR, but there again I drink fairly consistently. The trouble is, it's easy to get carried away in certain situations... it made me seriously consider my lack of willpower recently when I realised that 6 of us at a dinner party had got through almost 11 bottles of wine:eek:. Again my INR wasn't affected, but my liver probably needs a good rest!

[OldManEmu]

I am not on Warfarin so may not be what you are looking for. I was very cautious in the first 15 months post surgery as recommended by my cardio until my heart remodelled. Now with no other health issues I drink what I like however it is not to the stage of drunkenness. :)