Coumadin and Cranberry Juice

[MarcusKspn]

Hi everyone,

I have read recently that the UK is recommending people who are taking Coumadin not to drink cranberry juice. The believe is that a product in cranberry juice interacts with one of your bodies enzyme and prevents your body from breaking down coumadin, raising the blood levels and PT values to dangerous levels. I have not found any research proofing this theory though, and the FDA has been quiet about it. I was wondering if you other nurses have heard about this, and I am curious if any institutions have instituted like a "no-cranberry juice policy". I am also very curious to hear form our UK nurses and get some more info.

[kyutnurse]

I learned about cranberry juice is good for UTI, and grapefruit juice is good to help decrease cholesterol. That's all I know.

[saramints]

My name is Sara Lo and I am a junior nursing student at the University at Buffalo. I have been following the LSTSERV closely and wanted to post a reply to the member who asked about the interaction of cranberry juice and Coumadin.

There are many benefits of drinking cranberry juice, including the prevention of urinary tract infections, and its ability to fight heart disease by significantly raising levels of HDL (Cranberry juice helps, 2003). However, recent findings have shown that cranberry juice may interfere with drugs such as Coumadin (Cranberry juice dangerous, 2003).

McCabe (2004) notes that further studies of the potential untoward effects of cranberry juice on Coumadin is warranted after at least five case reports to the United Kingdom on food safety. In one case report, a man died from a gastrointestinal hemorrhage after his blood clotting levels changed dramatically after starting to drink the juice (Warfarin, 2004)

Although there is a lot of literature on this topic currently, there have been no evidence-based studies to confirm suspicions. Still, considering the five case reports and death of one patient, it may make good sense to caution patients on Coumadin to avoid drinking cranberry juice until further studies confirm otherwise.

Thank you for your time. I would appreciate any further comments on the subject.

ps. (Take a look at these references below, you might find something useful for you)

References

1. Cranberry juice may help fight heart disease. (3/25/2003). FoodNavigator.com Breaking News on Food & Beverage Development. Retrieved on February 13, 2004 from http://www.foodnavigator.com/news/news-NG.asp?id=46392

2. Cranberry juice dangerous with heart drug. (9/19/2003) FoodNavigator.com Breaking News on Food & Beverage Development. Retrieved on February 13, 2004 from http://www.foodnavigator.com/news/news-NG.asp?id=47465#

3. McCabe, B.J. (2004). Prevention of food-drug interactions with special emphasis on older adults. Clinical Nutrition & Metabolic Care, 7(1), 21-26.

4. Warfarin interaction: First report of an interaction with concomitant cranberry juice leading to fatal hemorrhage in an elderly patient: Case report. Reactions Weekly, 986:14, January 31, 2004.