The Anonymous Widower

Interaction Between Warfarin And Terbinafine

A few weeks ago I was prescribed a course of oral Terbinafine to clear up a fungal infection. It seemed to work well, except that there is still some of the tinea in my toe-nails.

But over the time, I was taking the drug, I have felt that my INR was constantly wanting to slip downwards towards and below two.

Luckily I test my INR daily, and use a simple control algorithm to calculate my Warfarin dose. Normally, it is 4 mg, but if it goes below 2.3, I increase it to 5 mg, and if it goes above 2.8, I reduce it to 3 mg. So the algorithm got me taking a lot of 5 mg doses as opposed to the usual4 mg.

Only since I finished the course of Terbinafine has the INR stabilised around 2.5, which is my target value.

I didn’t at first see any link until everything settled after the course finished.  But I decided today to type “Warfarin Terbinafine interaction” into Google. I found this paper from the BMJ entitled Drug points: Serious interaction between warfarin and oral terbinafine.

I think this minor incident shows the value of regular INR testing! Because I was testing daily, as the INR started to drop, my algorithm told me to increase the dose to 5 mg.  In fact my average dose has gone up from 4 to 4.5 mg. in the period that I was taking the Terbinafine.

So there was no harm done at all!

April 25, 2014 Posted by | Health | , , , | 2 Comments

Porridge For Those On An Extreme Diet

I bought this pot of Nairn’s porridge in Waitrose at Canary Wharf

Porridge For Those On An Extreme Diet

Porridge For Those On An Extreme Diet

Is it for those on extreme diets or is it a taste of what the English will get out of Scottish independence?

April 25, 2014 Posted by | Food | , | 2 Comments

My Itinerary For Gdansk

I’m putting my itinerary here, so I can get it at any time.

26/27 April – Gdansk

Arriving in Gdansk on Wizzair 1612 at 23:35.

Hotel Haffner

Restaurants

Goldwasser

Pueblo

28/29 – Warsaw

Trains to Warsaw from Gdansk

06:52 – 11:24

08:52 – 14:39

10:52 – 16:39

13:43 – 18:45

InterContinental

Restaurants

La Cantina

30 – Berlin

Trains to Berlin from Warsaw

09:55 – 15:16

Brandenburger Hof

Restaurants

Cielo di Berlino

1 – Cologne, Brussels, Amsterdam or The Hague

 

 

 

 

 

April 25, 2014 Posted by | Transport | , , , , , | Leave a comment