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FMCH Services » Anticoagulation Clinic (Coumadin)

Anticoagulation Clinic (Coumadin)

Anticoagulation Clinic (Coumadin)

319-376-2052
Held Monday-Friday, 8:00 am to 3:00 pm

Warfarin (Coumadin)

Anticoagulants, such as Warfarin, decrease the clotting ability of the blood and help prevent harmful clots from forming in your blood  vessels.  Often referred to as “blood thinners” they do not actually thin the blood.  Anticoagulants will not dissolve clots that have already formed.  Warfarin is often used to prevent formation of clots which have been associated with medical conditions such as deep vein thrombosis (blood clots in the leg), pulmonary embolism (clots in the lung), and an abnormal heart rhythm called “atrial fibrillation.”  Warfarin is also used to prevent clots (i.e. stroke) in patients with heart valve replacements or those that have recently undergone some surgeries such as a knee or hip replacement.

Blood Testing

The prothrombin time (PT) is a blood test used to evaluate how long it takes for the blood to clot.  Fort Madison Community Hospital has adopted the International Normalized Ration (INR) system of   reporting PT results.  The health care provider managing your Warfarin therapy will adjust your Warfarin dose based on your INR results.  Close laboratory monitoring will prevent blood clots from forming and will   decrease bleeding problems.   Initially, the INR will usually be checked once or twice weekly.  As the INR and dose of Warfarin stabilize, the blood test will usually be done every four weeks for as long as you are on the medication.  It is very important these blood tests are done; therefore compliance with laboratory appointments is necessary.

Proper Use of this Medication

Take this medicine exactly as directed by your health care     provider.  Do not take more or less of it and do not take for a longer   period of time than your provider recommended. 

  • Know the strength of the prescribed medicine.

Strength

Color

1 mg Pink
2 mg Lavendar
2.5 mg Green
3 mg Tan
4 mg Blue
5 mg Peach
6 mg Dark Green
7.5 mg Yellow
10 mg White
  • Take your Warfarin once each day at the same time.
  • If you miss a dose, take it as soon as possible if you remember the same calendar day.  However, if you do not remember until the following day, do not take the missed dose if you are within 8 hours of your next scheduled Warfarin dose.  Please notify your health care provider regarding any missed doses. 
  • Store this medication out of the reach of children and pets.

Be sure your understand any changes your provider makes with your medication.  If you have any questions or if you want more  information about this medication, please ask your health care provider.

Possible Complications

Do not be alarmed, but call your provider promptly if you  develop any of the following:

  • Unusual bleeding from gums (use a soft toothbrush)
  • Excessive bleeding or oozing from cuts or wounds
  • Nosebleeds
  • Unexplained bruising or purplish areas of the skin
  • Excessive menstrual bleeding
  • Red or dark brown urine; red or black stools
  • Severe or prolonged stomach pain or backaches
  • Severe or continuing headaches

Medication Interactions

Since many medications also interact with Warfarin, always ask your health care provider before taking any new medications, or before you stop taking any other medicine.  The risk of bleeding  complications may increase when aspirin and Warfarin are taken  together.  Please contact your provider before taking medications with any of the following ingredients; aspirin, salicylate, acetylsalicyclic acid or ASA. 

Common Over The Counter (OTC) Medications to Avoid Common Over The Counter (OTC) Medications to Avoid

  • Advil®
  • Bufferin®
  • Aleve®
  • Ecotrin®
  • Alka-Seltzer®
  • Excedrin PM®
  • Anacin®
  • Motrin®
  • Ascriptin®
  • Nuprin®
  • Aspergum®
  • Pepto-Bismol®
  • Bayer Aspirin®
  •  Orudis®

Medications that contain pain relievers similar to aspirin such as  ibuprofen (i.e. Motrin®, Advil®, Nuprin®) and naproxen (Aleve®) should be avoided.
Aspirin-free products which contain acetaminophen, such as Tylenol® are preferred for the treatment of pain or headaches.  Although, this is the preferred treatment, large doses of Tylenol® have been found to increase the INR.  Please alert your health care provider if you are taking more than 4 extra-strength (500 mg) Tylenol® per week.  If high doses of Tylenol® are needed, please try to take the same amount from week to week.
Some antibiotics used to treat infection may also interact with Warfarin and increase the risk of bleeding.  Please inform your health careprovider when you start or stop taking an antibiotic.
 

Diet

Foods rich in vitamin K can decrease your INR, therefore making it easier for your blood to clot.  You are encouraged to maintain the same general diet, but your intake of the following foods should remain the same from week to week.

Avocados Collard Greens Rhubarb
Broccoli Cucumber with peel Spinach
Brussels Sprouts Green tea Tomato
Boost/Ensure Kale Turnip Greens
Cabbage Lettuce  
Chickpeas Mustard Greens  

Avoid “binge” eating or “crash” diets.  Report to your health care provider any major changes in your food intake, such as a decreased appetite or weight reduction diets.

Alcohol Restrictions

Alcohol with Warfarin can cause the INR to increase (blood takes longer to clot) and may lead to dangerous bleeding complications.  Please limit alcohol intake to one serving daily for female patients and two servings daily for male patients.

Safety Precautions

  • Avoid activities that might cause injury.
  • Do not walk barefoot, especially outdoors.
  • Use extreme care while handling sharp objects, garden/farming tools and broken glass.

Alternative Medicines, Herbs and Vitamins

Many patients are turning to alternative medicines for treatment of their health.  You should be aware that many of these “natural”  products may contain ingredients that affect your response to Warfarin.  Please contact your health care provider prior to starting or stopping any alternative medications.  The following medications are known to interact with Warfarin and should be avoided.

  • Feverfew
  • Garlic (large doses)
  • Ginseng
  • Ginkgo Biloba
  • Vitamin E (>400 IU/day)

Changes in General Health

It is extremely important to advise your health care provider about any significant changes to your health.  Rapid changes in weight caused by illness with loss of appetite can significantly affect Warfarin.   In addition, any illness with prolonged nausea and vomiting, high fever, or diarrhea can affect your Warfarin and should be reported to your health care provider as your INR may need to be checked sooner than originally scheduled. 

Medic Alert Tag

It is very important you wear a medic alert tag and carry a  Warfarin ID card.  Inform all your health care providers including your dentist before undergoing any treatment or surgery.

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