--- title: Mental Health Blog | warfarin use description: warfarin use | Mental health blog for families, patients and health professionals in the Minneapolis / St. Paul area --- # Minneapolis St. Paul Mental Health Blog Select Category addiction ADHD ADHD in Children ADHD in Teenagers ADHD Minnesota Adolescent Mental Health Adults advanced practice nurses Aggression Aging air quality alcohol in kids Alcohol use Alzheimers Alzheimer's studies anxiety Anxiety Help APRN Minnesota APRN support ASD austim Autism Behavioral Problems benzodiazepine Bi Polar in children Binge Drinking biofeedback bipolar borderline personality disorder Brain Injury Bullying Caffeine Caffeine poisoning Cannabis Use cardiovascular events CBD Celiac Disease Children Mental Health clinical studies CNS Mental Health Coffee Cognitive Disorder corona virus Covid-19 and our Health dementia Depression Depression in College Depression in Men Depression in Women Depression studies help diabetes Diet Diet and Mental Health Drug Addiction Drug Overdose e-cigs Eating Disorders eating healthy ECT electronic devices evidence based improvement Excercise Exercise for Mental Health exercising mental health Expansion Medicaid Family Fasting fatigue and Covid FDA recall Fear and Phobias fibromyalgia Fish Oils fitness food and mental health Friday point of view Gender Identity Guns and Mental Health Gut Health hallucinations Headaches hearing heart attacks High School and Depression hospitalizations Hypertension IBS Insomnia internet gaming addiction ketamine kratom loneliness love and Mental Health Low Vitamin D Marijuana Use maternal health Medication discontinuation help Meditation Menopause Mental Health Mental health access Mental Health and eating Mental Health coverage Mental health help mental health in pregnancey Mental Health in Pregnancy Mental Health Risk Mental Health Studies Mental health Teenagers Mentally ill Metabolism methamphetamine use Migraines Minnesota APRN mood disorder Music Nightmares Nurse Practitioners Nutrition Obesity OCD Omega 3 Opioid Recommendations opioid use opposition to bill H.F.2803 pandemic Physican Assistants post partum depression Postpartum Depression pregnancy pregnancy and depression Prescription help psilocybin PTSD SAD help Schizophrenia scope of practice Seasonal Affective Disorder self care Senate 511 bill Serotonin S.F. 511 SF511 HF435 Sleep sleep apnea sleep help smartphone Smoking social isolation social media social support SSRI use Stigma and Mental health stimulants stress Stress Help Stroke Substance Abuse Disorder Sugary Drinks Suicide Supplements synthetic drugs Taurine TBI and Sleep TD Teenagers The Sheridan Story TMS Type 1 Diabetes vaping Violence vitamin D warfarin use withdrawl Women Depression Help Womens Mental Health youth depression This is a search field with an auto-suggest feature attached. - There are no suggestions because the search field is empty. Posts about: ## warfarin use ![](https://www.maryaprn.com/hubfs/green-cannabis-plant-3536257.jpg) [warfarin use](https://www.maryaprn.com/blog/topic/warfarin-use) ### [Warfarin & Cannabis Use impacts INR levels](https://www.maryaprn.com/blog/warfarin-cannabis-use-impacts-inr-levels) Fri, Feb 14, 2020 @ 06:00 AM ## Mental Health | A recently published report describes the case of a 35-year-old male patient who experienced a sudden elevation in his international normalized ratio (INR) ...due to an interaction between warfarin and cannabis and highlights the importance of close monitoring of patients who use these agents concomitantly. The patient, who had a past medical history of unprovoked left leg deep vein thrombosis, ST-segment elevation myocardial infarction, and attention-deficit/hyperactivity disorder (ADHD), had been stable on warfarin 10mg daily from 2010 to 2018. His INR goal was reported to be 2.5, with an accepted range of 2.0-3.0. At an INR follow-up appointment at a family medicine clinic in July 2018, the patient presented with an elevated INR of 7.2 but denied any symptoms of bleeding. “Upon further questioning, he reported smoking and ingesting cannabis for the past month at the recommendation of his psychiatrist for anxiety and ADHD,” the authors explained. The patient stated that he had been using cannabis edibles “almost daily” but denied any other medication or lifestyle changes. After the patient was instructed to discontinue all cannabis use and continue warfarin 10mg daily after holding 2 doses, his INR decreased to 1.2. Over the following 3.5 months, the patient’s INR consistently trended between 3 and 4, which the authors attributed to multiple dose adjustments as well as other confounding factors (ie, diet alterations, international travel). “The elevation in INR can be explained by the inhibition of CYP2C9 by cannabis use causing decreased metabolism of warfarin,” the authors explained. “The interaction between warfarin and cannabis was determined to be probable using the Horn Drug Interaction Probability Scale.” Based on their findings, the authors recommended that INR be closely monitored in warfarin-treated who are initiated on cannabis, although additional large-scale studies are needed to better understand the magnitude of this interaction. [MaryAPRN.com/ Advanced Practice Psych LLC](https://www.maryaprn.com/blog/author/maryaprn-com-advanced-practice-psych-llc) [Read More](https://www.maryaprn.com/blog/warfarin-cannabis-use-impacts-inr-levels)