Switching from Lovenox to Coumadin

Im 26, 200lbs male and have been on Lovenox 80mg for the past year. Im finally switching over to coumadin 5mg. The plan is my hematologist wants me to start taking coumadin on saturday and continue taking the Lovenox as well and then on tuesday ill get my blood tested in the morning and if the results come back good at night then i'll get off the Lovenox and stay on just Coumadin. My hematologist said you cant just stop Lovenox and go on the other because it may cause a reverse effect.
My question is that really dangerous to be on both Coumadin and Lovenox at the same time? I mean, my doctor put me on Lovenox for the past year because it was stronger. Thank you for any help!

I'm new to the coumadin issue, but as explained to my husband in the hospital Lovenox provides immediate but short-term protection from clotting while it takes about 3 days for Coumadin to build up to acceptable levels. If there is any anticipation of surgery or other invasive procedures the doctor would want you on Lovenox so it could be out of your system within 12 hours. It's customary to be on both Lovenox and Coumadin until the Coumadin kicks in.

I was on Coumadin and Lovenox for a while myself. It is completely safe.

I have been given Lovenox at the same time as Coumadin. The Lovenox has been used while my INR was not at clinical levels of between 2 and 3.

Everyone is right - Lovenox is "usually" only used as a go between - until you are into range using Coumadin. Scott,I honestly have Never heard of anyone being on Lovenox for a year. Lovenox is extremely expensive and most insurance companies will only cover it for short periods of time. Lovenox really isnt "stronger" than Coumadin, it just works differently. I am surprised you were on it for so long because you cant measure how thin your blood is on it.
**If you dont mind me asking - why were you on Lovenox to begin with? If you dont want to answer thats okay - Im just curious why Lovenox was used for so long.

I am going to have small surgery on my index finger, surgeon said to stop my coumadin 5 days prior, I am Protein S deficient and had a blood clot in my leg 6 months ago, they had a hard time getting my numbers up and I am on 15 mg a day. No lovenox or heparin drip before or after Is this okay?????

I am not a doctor or nurse, but number one, NEVER have another doctor tell you what to do about your coumadin without consulting with the doctor that prescribes and monitors your coumadin.

In other words, let your coumadin prescribing doctor know about the procedure and ask him/her what he would want you to do.

It seems entirely unreasonable to me to just not have you on anything for this long, especially considering your circumstances.

Actually some of my doctors don't even take me off the coumadin for minor procedures as they would rather deal with a little more bleeding rather than worry about a clot.

At a minimum, I would want lovenox shots during the time of no coumadin.

Laurie, what do you think?

Good luck Suzy, and please check into this more before you just stop the coumadin.

All the best,

Angela

I agree Angela. The only doctor that should ever tell you to stop your Coumadin for a procedure is the one who manages you. Surgeons and other doctors dont have a clue about the risks. I fought with many a doctor for taking my patients off Coumadin - if I could have gone thru the phone, they would have been sorry :) Always, Always ask your managing physician - many times they will reduce the amount of days and possibly use Lovenox in the interim or bolus you for a few days after surgery. By bolus, I mean increase your dose for a couple of days. Good luck Suzy, talk to your doctor before doing that.

To illustrate further: I have to have a colonoscopy very soon, but the performing doctor only asked me to contact my "coumadin doctor" to get me off safely. He refuses to do that and always directs his patients back to their prescribing doctors. I appreciate that.

Hope all goes well......sending my prayers and best wishes to all of us....

In response to Laurie, I was on Lovenox for years, mainly becuase of pregnancies after a PE, but for about a year because they could not get my coumadin levels normal from being on high doses of prednisone for asthma. Lovenox was the only way to go at that time.

I have been on coumadin for 1.5 years becasuse of a DVT/PE and a "slightly" elevated Factor VIII. I'm having arthroscopic knee surgery next week and I am bridging off my coumadin and onto Lovenox while I type this.:-) My only concern is this: my surgeon told me not to take any coumadin nor lovanox until the day after surgery. I guess that one day is scaring me. Should I be concerned that I have no blood thinner for 1.5 days (my sugery is in the am)?
My primary doctor is next to impossible to get hold of and I love my surgeron. I trust him, but I also am still worried about another blood clot. Any advice?

my wife was put on lovenox 100 mg and .05 coumadenafter after surgery. her protime shot up and she had a brain bleed and had to be rushed to hospital. stayed in hospital for 6 months and is now paralized and can only use her right arm. she is in bed for rest of her life, so be careful with use of lovenox and coumaden. result can be deadly.

Walter, that is so unusual - I am so sorry to hear about your wife. What kind of surgery did she have? Were they checking her INR frequently after she went home? Once again I am sorry about what happened and wish her well.

My 78 year old father was on coumadin since Sept. He went into the hospital the end of Nov. His PT/INR was within range and the put him on Lovenox. Needless to say, my dad died from internal bleeding 5 days before Christmas. I wouldn't recommend the two together.

Moe wrote:

My 78 year old father was on coumadin since Sept. He went into the hospital the end of Nov. His PT/INR was within range and the put him on Lovenox. Needless to say, my dad died from internal bleeding 5 days before Christmas. I wouldn't recommend the two together.

Moe,
I am so sorry for your loss. Why was your dad put on coumadin AND lovenox? Or were they bridging him so they can perform some kind of procedure on him?

Laurie
My wife had gastric bypass surgery. Doctor checked her pt/inr 5 days after surgery and it was extremely high, was sent home and brain bleed happened next day.

Walter, how high was it and why was she sent home like that? Did they give her vita k to bring it down? Didnt they keep her until is was down? I am sorry to hear about your wife.

Laurie
They checked it at lab in doctors building and said they would get results and let us know. We were sent home and she had brain bleed the next day and was admitted to hospital. Doctors office called us about her pt being extremely high and told her to stop taking the coumaden and Lovenox.
But we were already at hospital before for brain bleed when they called. They gave her vitimin k and another drug and transfered her to large hospital where the brain surgeon said he could not operate on her until her blood pt was 2.
No one ever told us how high it was at its worst.
We have not seen original doctor who did her gastric bypass surgery, since the day of surgery. He has avoided us since.

Walter, I am so sorry. I cant believe that after having a serious surgery that they would have allowed her to go home without knowing her INR. Is your wife back on the coumadin now? Who is managing her bloodwork if she is? How is she doing?

Laurie wrote:

Walter, I am so sorry. I cant believe that after having a serious surgery that they would have allowed her to go home without knowing her INR. Is your wife back on the coumadin now? Who is managing her bloodwork if she is? How is she doing?

She is not on coumadin or lovenox. She is on no blood thinners at present time. Our family doctor is seeing her now. She spent 6 months in hospital from june 6 2007 to dec. 2007 and is at home in hospital bed with no improvement after 1 yr. of therepy. She has to have nursing 24 hrs a day.