Coumadin is an anticoagulant medication commonly referred to as a blood thinner. The use of coumadin is important in the treatment and prevention of clot formation. Many patients using coumadin may also have cardiovascular disease. Fish oil supplements are often popular amongst patients with heart disease. Unfortunately, the use of fish oil can increase the risk of bleeding in patients taking coumadin.
Coumadin
Bristol-Myers Squibb manufactures and distributes coumadin for the treatment and prevention of blood clots. Coumadin is often used in patients with atrial fibrillation, deep vein thrombosis, pulmonary embolism, stroke, or other conditions that place patients at risk of blood clots. The anticoagulation effect of coumadin comes from the drug's ability to inhibit the synthesis of vitamin K-dependent clotting factors. Unfortunately, coumadin has a very narrow therapeutic range and routine monitoring of the internationalized normalized ratio or INR, a measurement of clotting time, is required. In addition, the potency of coumadin is affected by many drugs, foods and health conditions.
Fish Oil
Both omega-3 and omega-6 fatty acids are known as essential acids and must be obtained from dietary sources. Omega-3 fatty acids include alpha-linolenic acid, or ALA; docosahexaenoic acid, or DHA; and eicosapentaenoic acid, or EPA. The typical western diet contains plenty of omega-6 fatty acids and ALA. However, EPA and DHA are mostly found in fatty fish including mackerel, lake trout, salmon, sardines, herring and albacore tuna. Fish oil has been found to have benefits in heart disease and lowering cholesterol.
Fish Oil and Bleeding
According to the American Heart Association, fish oil can affect the clotting time of blood. The mechanism is believed to be multi-factorial including inhibition of clotting factors and platelet aggregation. In addition, fish oil has been associated with increased levels of compounds such as tissue plasminogen activator, which work to dissolve clots.
Fish Oil and Coumadin
Often times, patients using coumadin also have cardiovascular disease. Many patients using coumadin may also be using fish oil due to the reported benefits of omega-3 fatty acids toward cholesterol and heart disease. Since fish oil may affect clotting times, the simultaneous use with coumadin can increase the risk of bleeding.
Warnings
Patients using coumadin should always speak to a physician before using fish oil supplements. Uncontrolled bleeding can be a serious and life-threatening medical condition. Factors that increase the risk of bleeding include unstable warfarin dosing, surgical procedures, injuries, bleeding disorders and certain health conditions or medications.
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