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Questions for Dr. Kennedy
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Vitamin C and Coumadin
Posted by: George
Date: October 20, 2003 2:35 AM

I currently take 5 mg. and 7.5 mg. Coumadin on alternate days due to atrial fibrillation. Will large doses of Vitamin C (3-4g/day) affect the performance of the Coumadin? If so does Vitamin C inhibit or increase the prothrombin time? At what levels of Vitamin C will I see the prothrombin time change?

RE: Vitamin C and Coumadin
Posted by: Ron Kennedy, M.D.
Date: October 20, 2003 4:07 AM

You are thinking of vitamin E. Vitamin C does not have an effect on prothrombin time. Large doses of vitamin E do in fact affect the prothrombin time (slows clotting). There is no formula I am aware of to predict the exact effect a particular dose will have. In the case of someone already taking coumadin, if that person wants to use vitamin E in addition to, or in place of, coumadin then frequent prothrombin times should be done in the transition period and coumadin adjusted downward in accordance with the results. The reason for such caution, of course, is the possibility of the pro time going too high and thus running the risk of uncontrolled bleeding. Final doses of vitamin E which people take in such cases are in the 1600 to 2400 unit range. However, one should not start there, but rather build up over a couple weeks in 400 unit increments.

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