1. What is Coumadin?
Coumadin (also known as Warfarin) is an anticoagulant medication that decreases the blood's ability to form clots. It reduces the tendency to form clots by blocking the production of certain clotting factors normally controlled by vitamin K. Vitamin K is a dietary vitamin ingested with many different green vegetables. Coumadin blocks the action of Vitamin K within the liver and thus reduces the clotting action of blood. Coumadin is available as a prescription item only and comes in several strengths ranging from 1 to 10 milligrams.
2. Why am I taking Coumadin?
Your doctor has prescribed Coumadin for you because you have a tendency to form blood clots. Blood clots form in people who have artificial valves, irregular heart beats (atrial fibrillation), or clotting disorders. Blood clots that form when they shouldn't can be dangerous. These clots can break loose and obstruct blood flow. Continuous blood flow is very important because it provides nutrients and oxygen to every cell in your body.
3. What are the effects of Coumadin?
If the dose of Coumadin is too high or if some other factors interfere, there may be bleeding. You should observe closely for unusual bruising that enlarges, nosebleeds that do not stop, blood in the urine (red or brown urine), blood in the bowel movements (red or black stools), bleeding gums, excessive menstrual flow, or bleeding from a skin wound that does not stop with direct pressure.
4. What should I do if I notice any bleeding?
If you have any concern over bleeding and if it does not stop, you should go to an Emergency Room or call 911.
5. How do I know if the Coumadin is working?
It can take several days to see the initial effects on the blood test after taking Coumadin. You will require frequent monitoring with a blood test called the prothrombin time. The test results are reported in seconds and with a ratio called the International Normalized Ration (INR). The test result will be individualized for you, but the INR is usually between 2.0 and 3.5. INR values of 1.0 suggest that there is no Coumadin effect. INR values of greater than 5.0 can be dangerous.
6. How often will I need to have my blood tested?
In the beginning you will need to have your blood tested as often as twice a week. As the dose becomes stable, you will need blood tests at least once a month.
7. What factors may influence my dose?
Various factors may change the response to Coumadin including other drugs, changes in diet, the flu, any illness associated with a fever, other medical conditions and of course changes in the dose. You must let all health care providers know of any changes in your medication or condition. Common drugs that can affect Coumadin are aspirin, alcohol, antacids, antihistamines, and antibiotics.
8. Is it necessary to change my diet while taking Coumadin?
It is not necessary to change the content of your diet because of Coumadin, however you should follow any other dietary restrictions such as low sodium or low fat. Foods which contain high amounts of Vitamin K include: Kale, spinach, broccoli, cauliflower, brussel sprouts, beef, pork, or chicken liver, soy protein products (including tofu), and vitamins A and E. If your regular diet already contains these food items, DO NOT change your eating habits. Consistency with your daily eating pattern in the key!
9. When should I take my dose?
You should take the dose at the same time every day, preferably in the evening. The evening is preferred because it is easier to make adjustments on an evening dosing schedule. If you should miss a dose DO NOT take an extra dose, just skip it.