Question
Patient diagnosed with multiple small bowel telangectasia. Meds being taken are coumadin 4mg/5mg alternating days, lipitor 40mg/da, methotrexate 10mg/wk, Toprol XL 50mg/day. Arava discontinued in March of 05. Is there a danger of bleeding if Arava therapy reinstutited. INR kept below 2.5.
Answer
There should be no danger of bleeding with Arava unless it affects the platelet count (rare) or it affects the metabolism of coumadin and raises the protime/INR test. Thus, the protime should be monitored carefully.
