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Oral Anticoagulation Warfarin (Coumadin)

What is Coumadin?

Coumadin is an anticoagulant drug. It helps reduce clots froID forming in the blood. Coumadin is a narrow therapeutic index drug, which means that there is a narrow margin between too much and too little of Coumadin. Too much drug may cause you to bleed more. Too little drug may let a harmful clot form.

Why Am I Taking Coumadin?

Coumadin is used to help prevent and treat blood clots that are associated with an irregular heart beat called atrial fibrillation. It is also used to prevent and treat blood clots that are associated with mechanical valve replacements or blood clots in the legs or lungs and some other conditions associated with abnormal blood clotting.

How Does Coumadin Work?

Coumadin partially blocks the reuse of Vitamin K in your liver. Vitamin K is needed to make clotting factors that help the blood to clot and prevent bleeding. Vitamin K is found naturally in foods such as leafy, green vegetables and certain vegetable oils. Coumadin reduces the level of active clotting factors in your blood as a result of its effect on Vitamin K.

When Does Coumadin Start to Work?

Generally Coumadin begins to reduce blood clotting within 24 hours after taking the drug. The full effect may take 72 to 96 hours to occur. The anti-clotting effects of a single dose of Coumadin last 2 to 5 days. It is important for you to take your dose as prescribed.

How Much and When Should I Take Coumadin?

Coumadin dosage is based on your INR (International Normalized Ratio) blood test. This is a standard way of reporting protimes. Coumadin should be taken the same time every day. It is best to take Coumadin at your evening meal or at bedtime.You can take Coumadin either with food or on an empty stomach.

How is Coumadin Adjusted?

Dosage of Coumadin is based on your INR. When you initiate therapy with Coumadin you will have frequent INR tests. After your INR level is therapeutic and stable and will be asked to have monthly INR tests. Many medications and over the counter products and herbs affect INR levels so please let us know before starting, changing or stopping any drug or herbal medicine. Commonly, antibiotics will increase INR so call the office and have an additional INR test done during antibiotic use.

Are There Any Foods That May Interfere with Coumadin?

The amount of Vitamin K in your daily diet may affect Coumadin therapy. High amounts of Vitamin K decrease the effects of Coumadin. In general, green, leafy vegetables and certain vegetable oils contain high amounts of Vitamin K. Eat a normal, balanced diet maintaining a consistent amount of Vitamin K. Avoid drastic changes in dietary habits.

What Are the Side Effects of Coumadin Therapy?

The most common side effect of Coumadin is bleeding in any tissue or organ. To lower the risk of bleeding, your INR should be kept within a range that is right for your prescribing condition. Please contact us if you experience signs or symptoms of bleeding, such as:

  • Bleeding from shaving or other cuts that do not stop
  • Nosebleeds
  • Bleeding of the gums when brushing your teeth
  • Throwing up blood
  • Unusual bruising (black and blue marks on your skin) for unknown reasons
  • Red or dark brown urine
  • Red or black color in your bowel movement
  • More bleeding than usual when you get your menstrual period or unexpected bleeding form the vagina
  • Sever headache
  • Fainting lightheadedness

Any Other Important Information I Need to Know While I Am on Coumadin?

Always tell any physician or dentist you see that you are taking Coumadin. Any planned surgery needs to be discussed with the surgeon and decisions whether to stop Coumadin for a short period of time need to be made.

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