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Originally published Sunday, November 9, 2008 at 12:00 AM

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Cranberries don't mix with Coumadin

Q. I am having trouble leveling out my Coumadin. Many foods are not included on the list the dietitian gave me. Cranberries are a puzzle...

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Q. I am having trouble leveling out my Coumadin. Many foods are not included on the list the dietitian gave me. Cranberries are a puzzle, for instance. The nurse says eat them; the doctor says don't. Can I eat cranberries or not?

A. Trying to maintain a steady anticoagulant effect from Coumadin (warfarin) can be a little like walking a tightrope. Too much medicine can lead to bleeding, while too little may permit blood clots to form. Coumadin interacts with many foods.

Several cases in Great Britain led the health authorities there to warn against combining cranberries or cranberry juice with the anticoagulant Coumadin (warfarin). Some people who had been on a stable dose of Coumadin had serious bleeding problems after drinking cranberry juice or eating cranberries.

Australian scientists have reported that cranberry significantly increases warfarin's anticoagulant effect (British Journal of Pharmacology, August 2008). We suggest you follow your doctor's recommendation and avoid cranberries and cranberry juice while you are taking Coumadin. You will find a free Guide to Coumadin Interactions at www.peoplespharmacy.com.

Q. My hemorrhoids were burning and itching, and even Preparation H didn't seem to help. Since zinc oxide is used in diaper cream, I thought why not give it a try?

From the first time I used it, I have not had any recurrence of the symptoms. At first I applied it every night, but now I only use it once a week or less.

A. We could find only one reference to the use of zinc oxide for the itching and burning of hemorrhoids. A German salve (Mirfulan) that contains zinc oxide plus witch hazel, urea and vitamins A and D was reported helpful (ZFA Stuttgart, Oct. 20, 1979).

Q. Every winter, my skin gets awfully dry and itchy. My hands and particularly my fingertips really suffer. At times they crack and bleed. I would be so grateful if you would send me any information you have.

A. As indoor-heating systems come on, humidity drops. That may be why dry skin is worse in the winter. Washing hands frequently to avoid colds or flu also aggravates dry skin.

Readers have suggested a variety of solutions, including O'Keeffe's Working Hands Cream, TheraSeal Hand Protection and Lotil Cream. Inexpensive farmers' moisturizers such as Bag Balm, Corn Huskers Lotion and Udder Cream also are popular.

Cracked fingertips can be extremely painful, and moisturizing isn't always enough. Some readers use ChapStick or liquid bandage on split skin.

In their column, Joe and Teresa Graedon answer letters from readers. Write to them c/o King Features Syndicate, 888 Seventh Ave., New York, NY 10019

Copyright © 2008 The Seattle Times Company

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