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School of Medicine
Coumadin (warfarin) is an anticoagulant or “blood thinner” that helps prevent your blood from forming harmful clots. As blood passes through a mechanical valve, there is a tendency for blood clots to form, which means that you will need life-long anticoagulation. Unlike a mechanical valve, a tissue valve or ring is less likely to form clots. If you have a tissue valve implanted, you may be started on Coumadin for six weeks, after which it is stopped. You may also be on aspirin daily.
A blood test called an INR must be done within two to three days after you are discharged home. The doctor who follows your Coumadin therapy will tell you how much of the drug to take daily and when to report for the next blood test. Generally, you will need to have a blood test one to two times per week so the doctor can decide the correct dose. When the results of your blood tests have stabilized, you will only need to have a blood test once a month.
What restrictions or precautions will I need to take if I am on Coumadin?
- Avoid nonsteroidal anti-inflammatory drugs (NSAID) medications, such as cold remedies, pain relievers, arthritis medications, antibiotics and many more, because they may strengthen the effects of Coumadin. You may take Tylenol. NOTIFY the person following your Coumadin therapy before taking any other medications.
- Limit foods that are high in vitamin K, such as dark green leafy vegetables (kale, spinach, broccoli, etc) and fish (trout, tuna, salmon, etc); this does not include shellfish. Limit alcoholic beverages (wine, whiskey, beer, etc) to one or two drinks per day, if desired. Avoid the above food and drink on the day before your blood test is drawn.
- Take Coumadin as ordered at the same time each day. Do not stop the drug or change the dose without a doctor’s order. If you have any questions about your Coumadin therapy, be sure to ask your doctor. Please keep a daily record of the drug to prevent missing a dose or taking it twice.
- Report to your doctor any blood in the urine, black stools, prolonged or new nose bleeds or menstrual periods, bleeding gums, bruising for any unknown reasons, or spitting/coughing up of blood, or new headache.
- If you note any unusual swelling or pain, you should call the health care professional managing your Coumadin therapy.
- Head injuries should always be checked by a doctor. Having a headache, uncontrolled vomiting, blurred vision or confusion/sleepiness may indicate internal bleeding.
- Notify the person managing your Coumadin of any procedures you are planning to have (dental, cystoscopy, surgery, barium enema, etc.). Also, inform any doctor treating you that you are on Coumadin.
- Avoid situations that have a high risk of injury (playing contact sports, using a straight edge razor, walking barefoot, etc.) since you have an increased tendency for bleeding.
- Carry an identification card and wear a Medic Alert bracelet or chain to notify others that you are on a blood thinner. You may obtain this by writing to: Medic Alert, 2323 Colorado Avenue, Turlock California 95382 USA, 1-800-ID-Alert (1-800-432-5378) www.medicalert.org