Do NSAIDs Interact With Coumadin?

Last Editorial Review: 1/11/2018

Ask the experts

I am doing some research for my father, who has a right hand that is greatly swelled and in pain due to arthritis. This has never been a problem before because he cannot take anti-inflammation drugs because of other anticoagulants he is taking for a heart condition and high blood pressure.  He used to take Indocine for the arthritis and gout, but is restricted from it now.  One of the heart drugs he takes is Coumadin.  Is there anything he can take to relieve the swelling and pain of the arthritis that won't interact with the Coumadin?

Doctor's response

Traditional anti-inflammatory drugs, called NSAIDs (nonsteroidal anti-inflammatory drugs) are avoided when taking anticoagulants including coumadin.  This is because they impair the action of a major blood clotting element called platelets and because they are associated with ulcer formation in the stomach, esophagus, and small intestines.  These associated side effects increase the risk of serious bleeding, especially when taking anticoagulants (blood thinners).

Pain relief from arthritis can also be achieved with medications for pain, such as acetaminophen (Tylenol) or narcotics.  There is also a newer class of anti-inflammatory medications, which can relieve swelling and inflammation form arthritis and which do not carry the same risk of bleeding as traditional NSAIDs.  This newer class of anti-inflammation drugs is called cox-2 inhibitors.

Cox-2 inhibitors may be used in patients who are taking blood thinners such as coumadin.  Examples cox-2 inhibitors are Celebrex and Vioxx.

For more, please see articles, Celebrex, Vioxx, Celebrex Interview with Dr. William Shiel, NSAIDs.

Thank you for your question.


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