|Coumadin and hiv meds
Jan 3, 2007
Hi, I'm a newly dx HIV poz, female who was in the hospital for a DVT. I'm on coumadin for it. I have only had a theraputic level in Sept when I was in the hospital and getting lovonax injections and coumadin, and on Sustiva, Truvada. I had such depression and other side effects, my MD took me off it and put me on Viramune, and truvada. Now I can't get my pt/INR levels to go up. I have been 1.0-1.4, but more closer to 1.2. I'm on 6.5mg of coumadin right now and it hasn't changed yet. What should I do? I asked my provider to at least increase the coumadin by 1mg instead of the 0.5, but I'm thinking maybe I should go to a hemotologist/onc for help getting me at a theraputic level.I'm sick of getting finger stuck each week to see no new results. Thanks for your help.
| Response from Dr. Henry
Nevirapine (Viramune) can induce liver enzymes to work faster resulting in lower levels of coumadin so your situation can pose a challenge. Getting a hematologist or pharmacologist/pharmacist involved along with your HIV specialist is often very helpful. For some patients low molecular weight heparing in used in this setting as an alternative to coumadin. KH
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