Warfarin and Tattoos….To Tat or Not to Tat…

I just joined a listserv for ambulatory care, and a question came up about what the protocol would be for a patient on warfarin who wanted a tattoo. Seems we are talking a large tattoo also, not just a little ankle adornment. This is the compilation (not done by me) of what the opinions of the pharmacists were:

  1. The tattoo artist should be informed that the patient is taking warfarin; some artists may refuse to give the tattoo
  2. There is a risk of increased bruising, bleeding, and ink leaking under the skin
  3. Patients should pre-medicate with amoxicillin 2000 mg before the procedure
  4. Patients should discuss risk/benefit with health care provider(s)
  5. Some of you advise against tattoos, while others do not

***Seems this patient had a prophylactic dose of amoxicillin, took half of the usual pt dose of warfarin the night before, had a tattoo session lasting 5 hours, and with no ill effects.

Curious if anyone out there has had any experience with this?