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Tylenol and Blood Thinner May Not Safe

3-03-1998 - People who often take Tylenol or any other
form of acetaminophen along with a widely used blood-
thinning drug may risk deadly internal bleeding.
	A study has confirmed a hazard that has been
known for decades but not talked about. Frequent doses
of acetaminophen (the active ingredient in Tylenol)
increase the blood-thinning effect of warfarin, a drug
used to prevent strokes and heart attacks, say researchers
in Wednesday's Journal of the American Medical
Association.
	"While acetaminophen generally is a very
safe drug for pain and fever, people on warfarin who take
Tylenol for at least 7 days in a row should be closely
watched for bleeding," said the study's lead author, Dr.
Elaine Hylek.
	Warfarin, also known as Coumadin, is taken
by millions of people with a heart condition called atrial
fibrillation (a-fib) to prevent formation of blood clots that
can cause strokes.
	It is also taken to prevent clots around replaced
heart valves and to dissolve clots in the legs or lungs.
People taking warfarin often choose acetaminophen for
every day pain relief in the mistaken belief that it will not
thin their blood. Aspirin is known to thin the blood and
both aspirin and ibuprofen (another widely used pain
reliever) can damage the stomach lining.
	Warfarin's effects can be altered by many things
 - illness, other drugs, even certain foods - so treatment
involves a delicate balance. Too little blood-thinning can
cause a clot that could cause a stroke while too much
thinning can lead to deadly internal bleeding.
	Patients on long-term warfarin treatment
should get a monthly blood test called an INR, or
international normalized ratio, that measures how thin
your blood really is.
	An expert, Dr. William Bell of Johns Hopkins
University School of Medicine, said that if patients must
take warfarin and acetaminophen at the same time, their
blood thinness should be measured once or twice a week
and their INR should not exceed 4.

JON'S NOTE: The dose of Tylenol that caused dangerous
reactions in some people was relatively low - just a few
Tylenol per day for a week, in addition to their Coumadin.

Don't forget that Tylenol PM to help you sleep has a large
dose of Tylenol in it so BE CAREFUL!

Source: Associated Press.