Interaction of Marcumar with Alcohol & Drugs
September 3, 2010 | 20,00 EUR | answered by Dr. med. Olaf Stephan
Hello,
I have to take Marcumar for some time because I had a TIA, which is due to a PFO.
I cannot discuss certain topics with my general practitioner for private reasons and am now seeking advice here. I read on the internet that during the intake of Marcumar, one should not consume any drugs, especially amphetamines and cocaine, because they are highly dangerous in combination with my blood thinner, or even more dangerous than they already are. The same applies to alcohol to some extent. I am aware that drug use in general is harmful and excessive alcohol consumption is also harmful, but I would like to ask you to give me an honest answer to the following questions:
Would occasional drug use/high alcohol consumption be immediately life-threatening for me as a Marcumar patient? If so, why? I was explained that Marcumar is not a blood thinner but a blood clotting inhibitor, meaning that only the clotting factors in the blood are suppressed. Would the consumption affect the effectiveness of Marcumar or make it uncontrollable?
Thank you for your help!
Dear Inquirer,
Marcumar is the antagonist (opponent) of Vitamin K. Vitamin K is needed as a co-enzyme to synthesize various clotting factors in the liver. Without Vitamin K, these factors cannot be produced, the blood's ability to clot decreases, artificially turning you into a so-called "bleeder", meaning that in cases of injury or accidents, there can be a high and sometimes life-threatening blood loss without medical help. Internal bleeding or increased bleeding after trauma (accidents) is also favored. The warning on the package insert not to use the medication when consuming alcohol and drugs mainly results from the fact that in a state of intoxication, there is an increased risk of injury and therefore a greater risk of bleeding, also, in a state of intoxication, the ability to critically assess situations may be so impaired that the patient does not recognize the need for medical help. With severe alcohol abuse, there is often damage to the liver's synthesis capacity, so that the blood clotting is already impaired, further reducing the blood's ability to clot through medication also endangers the patient. I cannot recommend the use of alcohol and drugs, but occasional consumption would only pose the risk of injury while intoxicated, followed by severe bleeding, there is no direct interference with the medication. Therefore, you must decide for yourself if you want to expose yourself to this risk. By the way, in the case of an open foramen ovale as a source of embolism, the foramen in the heart septum can be minimally invasively closed using a catheter procedure with a small shield, for this you should consult a specialist in cardiology.
Yours sincerely, O. Stephan.
