Coumadin (Warfarin)

Do's: 

• Take Coumadin exactly as directed by your healthcare provider, typically once a day, by mouth with or without food. The dosage of Coumadin is determined by your medical condition, lab tests (such as INR - International Normalized Ratio), and response to treatment. This is typically done through blood tests, such as the INR test, which measures how long it takes for your blood to clot. 
• Take Coumadin at the same time each day to help you remember and establish a consistent dosing schedule. 
• Take the missed dose as soon as you remember. 
• Maintain a balanced and consistent diet while taking Coumadin. 
• Regularly monitor your response to Coumadin to ensure effectiveness and safety. 
• Consult your healthcare provider if you are planning to go on a diet or make significant changes to your eating habits.

Don'ts: 

• Do not increase the dose, take Coumadin more frequently, or stop using it unless directed by your healthcare provider. 
• Do not consume certain foods rich in vitamin K, such as broccoli, cauliflower, cabbage, brussels sprouts, kale, spinach, and other green leafy vegetables, as they can affect how Coumadin works in your body. 
• Avoid sudden large increases or decreases in your intake of foods rich in vitamin K without consulting your healthcare provider. 

• Do not double the dose of Coumadin to make up for missed doses. Your healthcare provider will monitor your INR levels to determine the appropriate dosage for you. The frequency of INR tests may vary depending on your specific situation. 

Common side effects that may occur with the use of Coumadin:

• Bleeding gums and nosebleeds
• Bleeding from wounds or needle injections that do not stop
• Heavy menstrual periods or abnormal vaginal bleeding
• Blood in urine or bloody/tarry stools
• Coughing up blood or vomit that looks like coffee grounds
• Pain, swelling, skin changes, or discoloration anywhere on the body
• Sudden and severe leg or foot pain, foot ulcer, purple toes or fingers

This is not an exhaustive list, and other side effects may occur. If you experience any unusual or severe side effects while taking Coumadin,  contact your healthcare provider for medical advice.

Here are some warnings and precautions to consider when taking Coumadin:

1. Bleeding risk: Coumadin is an anticoagulant (blood thinner) that increases the risk of bleeding. Monitor for signs of bleeding, such as unusual bruising, nosebleeds, or blood in urine or stool.
2. Interactions with other medications: Coumadin can interact with many other medications, including prescription drugs, over-the-counter medications, and herbal supplements. Inform your healthcare provider about all the medications you are taking to avoid potential interactions.
3. Dietary considerations: Coumadin interacts with vitamin K, which is found in certain foods. Consistency in vitamin K intake is important to maintain the effectiveness of Coumadin. Consult a healthcare provider or a registered dietitian for guidance on maintaining a consistent vitamin K intake.
4. Regular monitoring: Regular blood tests, such as the International Normalized Ratio (INR) test, are necessary to monitor the effectiveness and safety of Coumadin. The INR test measures how long it takes for blood to clot and helps determine the appropriate dosage of Coumadin.
5. Pregnancy and breastfeeding: Coumadin can cause harm to the fetus, so it is generally not recommended during pregnancy. However, in certain cases, the benefits may outweigh the risks, especially for pregnant women with mechanical heart valves. Discuss the risks and benefits with a healthcare provider.