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CONTENTS INTRODUCTION
ACTION OF ANTICOAGULANTS
HOW DO WE MONITOR?
HOW TO TAKE Warfarin (Coumadin)
PRECAUTIONS WHEN TAKING Warfarin
Other medications and Vitamin
Diet and Exercise
Daily Activities
Illness and Emergencies
Pregnancy, Surgery, and Dental Work
Travel
SIDE EFFECTS
APPENDICES:
1. Dietary Precautions: Food high in Vitamin K
2. Medications that can affect Warfarin
3. Personal Dosage Calendar
INTRODUCTION
“Anti” means against and “coagulant” means causing blood clotting. Anticoagulant is the medication that controls the way your blood clots inside your blood vessels. The anticoagulant that is commonly prescribed by your physician is called Warfarin. Understanding this medication well will help you to reduce the complications rate and lead a more normal life while you are taking this medicine.
ACTION OF ANTICOAGULANTS
An anticoagulant helps your body control how fast your blood clots; therefore it prevents clots from forming inside the arteries, veins, or heart during certain medical conditions.
If you already have a blood clot in your blood vessels, Warfarin may prevent the clot from getting larger. It may also prevent a piece of clot from breaking off and travel to your lungs, brain or heart. Anticoagulant however does not dissolve the clot, and with time the clot may dissolve on its own. HOW DO WE MONITOR?
The blood tests that we do are called PT/INR (Prothrombin time/ International Normalized Ratio).
It helps to assess whether your medication is working. The tests are performed at the laboratory. The frequency of doing the test will be decided by the physician who is looking after you. The test result obtained helps the doctor to decide the correct dosage of Warfarin that you should take in order to keep a balance between clotting and bleeding.
HOW TO TAKE Warfarin (Coumadin)
| - | Take the dose as instructed once a day | | - | Take the dose at the same time each day | | - | It can be taken before or after food. | -
| If you forget to take the medicine one day, take the same dose the following day. DO NOT TAKE A DOUBLE DOSE. | | - | Refill the prescription 1 week before the end of supply to avoid missing a dose. | | - | Continue to take Warfarin as long as your doctor prescribes it. |
PRECAUTIONS WHEN TAKING Warfarin
It is important to follow the precautions when you are taking anticoagulant- Warfarin. Other medications and Vitamin Supplements Interactions with Warfarin are common. These include:
| - | Prescription medication | -
| Over the counter medication such as aspirin, pin killers, cough and cold medicines, antacids, laxatives etc. | | - | Vitamin preparations containing vitamin K or large amounts of vitamin E or C. |
Remember do not stop or start any medication without first consult your doctor. Diet and Exercise
| - | Eat a sensible and well balanced diet. | | - | Discuss with your doctor before starting any weight reducing diet or nutritional supplements. | | - | Large amount of foods high in vitamin K may change the way Warfarin works. | -
| Alcohol beverages can also affect how Warfarin works. Ask your doctor about the amount of beer or wine you may drink. | | - | Check with your doctor before starting any exercise or sports program. |
Daily Activities
| - | Use electric razor instead of razors to minimize chance of cuts. | | - | Use a soft toothbrush. Brush and floss gently to prevent bleeding from the gums. |
Illness and Emergencies
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| Apply for a “Medik Awas” identity card that states that you are taking Warfarin. In an emergency, you may not be able to speak for yourself | -
| Illness may change the way Warfarin works. Call your doctor if you have symptoms like vomiting, diarrhea, infections or fever. | -
| Avoid getting hurt. Even minor injuries must be watched closely for bleeding because Warfarin affects clotting. |
Pregnancy, Surgery, and Dental Work
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| If you are a woman who is taking Warfarin and you are planning to become pregnant, do discuss with your doctor about the possible risks and ways to reduce those risks. Inform your doctor right away if you become pregnant. | -
| You may need to have a blood test and may need to stop taking the Warfarin for a few days before having a surgical or dental procedure |
Travel
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| Check with your doctor before you travel. You may need to have a blood test and the dose adjusted before you leave. | -
| When you travel, carry your medicine with you at all times: do not put medications in checked baggage and do not leave them in the car. |
SIDE EFFECTS
Bleeding is the commonest side effect. Call your doctor if you notice any of the following signs of bleeding:
| - | Feeling tired or looking pale (symptoms of anemia) | | - | Bleeding from cuts that won’t stop after apply pressure for 10 minutes | | - | Bleeding from nose gums or ears. | | - | Menstrual bleeding that is heavier or longer than normal. | | - | Reddish or rusty colored urine. | | - | Bowel movements that look bright red or black and tarry. | | - | Bruises that appear without reason or become swollen or purplish spots on your skin. | | - | Vomiting blood | | - | Coughing up blood. | | - | Unusual piles bleeding. | | - | Unusual pain or swelling, especially in the joints. | | - | Unusual headache. | | - | Stomach or abdominal pain. |
Remember, Warfarin is safe and effective when used properly. Just spend some time to understand your medication well.
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Education 
