Aspirin should be used with caution in patients taking warfarin

Dear Ask The Doctor: Hi my husband has dvt. Two days ago he got a migrain headache..which he has had many in the past. He took excedrin migrain pill as he has in the past. The thing is, today he still has the headache not quite as bad as it was but its still there. Now about an hour ago he noticed little blood spots under his skin mostly on his ankles but it goes all the way up to and a little past his knees. We live in a small area in northern Mn and we have yet to find a doctor around the area that can explain anything about his condition. I should add that he is 40 years old and takes 15 mil of warfrin a day. I put his info below not mine...Thanks

Dear Jason:Excedrin® Migraine contains acetaminophen 250mg, aspirin 250mg, and caffeine 65mg. This preparation may have been beneficial for your husband in the past for migraine, but should not be administered in addition to warfarin, because of the high dose of aspirin in this preparation. Acetominophen based products are suitable , but may affect INR levels and regular monitoring of INR levels is necessary with prolonged use. Always check the product label, because many drugs are contra-indicated in a patient taking warfarin. I would advise discontinuing this preparation immediately and attending your husband’s family physician for an INR level, because bleeding under the skin, may be an indication that the INR level is elevated, and dose adjustment of warfarin may be necessary.