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H A N D B O O K
Managing Your Coumadin works by partially blocking the re-use of Vitamin K in your liver. Vitamin K is needed to make clotting factors that help the blood to clot and prevent bleeding. By blocking the Vitamin K, coumadin reduces the body’s ability to make clots and can stop harmful clots from forming or from getting larger. Coumadin does not break up existing blood clots.
Coumadin begins to reduce blood-clotting within 24 hours after starting the drug. The full effect may take Coumadin (generically known as warfarin) is
72-96 hours to occur. The effects of a single dose of a blood thinner. Your provider has prescribed medication can last 2-5 days. This means when you this medicine because your medical condition first start taking coumadin you may have to have benefits from your blood clotting more slowly testing every day for a few days, then perhaps one than normal. Coumadin helps prevent clots from forming in blood vessels and in the heart.
Once stabilized, you will still receive testing at periodic This is important in such conditions as stroke, intervals (such as one time per month) throughout an irregular heartbeat called atrial fibrillation, your course of therapy to keep the blood thinned in pulmonary emboli, deep venous thrombosis, the best range for your medical condition.
It is very important to take Coumadin exactly as Diet and medications can alter the effect of warfarin directed by your physician. Too much Coumadin can on the blood. Many foods you eat have Vitamin K cause bleeding, and not enough Coumadin can allow in them which help your blood make clots faster. Foods containing fat substitutes, such as Olestra (Olean) are supplemented with fat-soluble vitamins Your provider will determine how much medicine you including Vitamin K. Herbal teas that have tonka need by monitoring the blood clotting levels with beans, sweet woodruff or melilot should also be the PT/INR. You will need to have this blood tested limited because of high content of Vitamin K.
regularly, because the correct dose of warfarin for you can change over time. Based on the results, your FOODS RICH IN VITAMIN K:
physician will inform you what dosage of medicine you need and when these tests need to be done again.
Several things, such as sickness, diet, other medications (both prescription and over-the-counter) • Turnip greens, collard greens, • Spinach or physical activities may affect your PT/INR. You should inform your healthcare provider about any significant changes in your health, medicine or lifestyle to help them adjust your medication if needed. Also if you are going to have any procedure outside of our clinic, please let the performing provider know as well as us here at PMG.
You may eat these foods and should because they are important to healthy diet. However you should try to eat about the same amount of them each week. Limit your alcohol intake to no more than one or two drinks per day.
Always let your provider here at Pacific Some medications can interact and/or interfere with warfarin causing serious side effects.
to take before you begin taking them.
YOU SHOULD AVOID THESE
NON-PRESCRIPTION MEDICATIONS:
• Aspirin or any aspirin-containing products (acetylsalicylic acid). Many cold remedies contain aspirin.
• *Anti-inflammatories such as ibuprofen (Advil, Motrin, • Vitamin K, Vitamin C, Vitamin E, or other high potency • Laxatives such as mineral oil or Ex Lax• Antacids such as Maalox, Mylanta, or Gelusil with or just The side effects of Coumadin are excessive bleeding • *H2-receptor antagonists such as cimetidine (Tagamet) and allergic reactions. The most common side effect is bleeding into any tissue or organ.
Notify your physician if you develop any of the following symptoms: YOU CAN USE:
NOTE: The amount of acetaminophen should be as low as possible and
monitored carefully. High doses of acetaminophen can prolong the INR. • A general multivitamin that does not contain more than 100% RDA of various components and does not contain (bleeding doesn’t stop after 10 to 15 minutes) Q: What if I cut myself, get a cut that won’t stop Q: What if I want to travel while I take Coumadin? A: Make sure you let your healthcare provider know. You will need to have your testing at its regular schedule and may need to have a test prior to leaving or while on your trip. A: Stop your medicine. Let us and/or your You should also make sure you have enough Q: What if I want to participate in a sport or A: Do not take another tablet to catch up if it is A: Ask your healthcare provider first. You will the next day. Call your provider for directions. want to avoid any activity or sport which may If you realize the same day you were to take result in a serious fall or other injury.
your pill, go ahead and take it. Wait 24 hours before taking your next pill.
Q: Does cooking, freezing, or drying foods change A: There is little information about the effects A: The clot blocking effect last for an additional of cooking, freezing, or drying the Vitamin 2-5 days, then your blood returns to normal.
K content of foods. It appears the content is about the same in fresh foods as is in prepared foods.
COUMADIN DO’S
Do take your coumadin as your health care provider
Do take your Coumadin about the same time every day,
may have about the medication, Coumadin.
Do keep eating habits and activities similar each day.
Do get your bloodwork tested as instructed by your
Do refill your prescriptions according to your providers
Do notify all your physicians, your dentist, and
conditions, it has significant risks involved pharmacists that you are taking Coumadin or warfarin.
You may want to wear a Medic Alert bracelet.
Do watch for signs of bleeding.
Do tell your healthcare provider when you are sick, hurt,
or get a cut that won’t quit bleeding.
Thank you for allowing us to serve as your COUMADIN DON’TS
• Do not take generic warfarin with Coumadin pills unless
specifically directed by your healthcare provider. They are the same medicine.
• Do not skip a pill and never double up on pills if you have
missed a dose. Notify your physician if you have missed any pills.
• Do not take any medication, including over-the-counter
(non-prescription) medications without informing your doctor.
• Do not take coumadin if you become pregnant.
Pregnancy requires special restrictions and management of coumadin. Notify your physician immediately if you become pregnant while on warfarin.

Source: http://www.pacificmedicalgroup.com/uploads/Managing%20your%20Coumadin_non-handbook%20format.pdf

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