Warfarin: Overview
Warfarin is a medicine that you take to prevent blood clots. It is often called a blood thinner. Doctors give warfarin (such as Coumadin) to reduce the risk of blood clots. You may be at risk for blood clots if you have atrial fibrillation or deep vein thrombosis. Some other health problems may also put you at risk.
Warfarin slows the amount of time it takes for your blood to clot. It can cause bleeding problems. Even if you've been taking warfarin for a while, it's important to know how to take it safely.
Foods and other medicines can affect the way warfarin works. Some can make warfarin work too well. This can cause bleeding problems. And some can make it work poorly, so that it does not prevent blood clots very well.
You will need regular blood tests to check how long it takes for your blood to form a clot. This test is called a PT or prothrombin time test. The result of the test is called an INR level. Depending on the test results, your doctor or anticoagulation clinic may adjust your dose of warfarin.
What foods are sources of vitamin K?
Leafy green foods like kale, spinach, collards, brussels sprouts, and cabbage are high in vitamin K. Broccoli, cabbage, okra, black-eyed peas, and some lettuces are also sources of vitamin K.
Taking warfarin safely
These steps can help you take warfarin safely.
- Follow the instructions for taking warfarin properly.
- Take your medicine at the same time each day.
- If you miss a dose, don't take an extra dose to make up for it. Your doctor can tell you exactly what to do so you don't take too much or too little.
- Get regular blood tests.
The test results tell your doctor whether your dose needs to be changed. Do not change your dose unless your doctor tells you to.
- Prevent falls and injuries.
For example:
- Wear slippers or shoes with nonskid soles.
- Remove throw rugs and clutter.
- Rearrange furniture and electrical cords to keep them out of walking paths.
- Keep stairways, porches, and outside walkways well lit. Use night-lights in hallways and bathrooms.
- Be extra careful when you work with sharp tools or knives.
- Be careful with other medicines.
Many medicines can affect how warfarin works.
- Tell all of your doctors, dentists, and pharmacists that you take warfarin.
- Give your list of medicines to every doctor and dentist who treats you. Include all of the prescription medicines, over-the-counter medicines, antibiotics, vitamins, and herbal products that you take.
- Talk to your doctor before you start or stop taking any medicines, vitamins, or natural remedies.
- Don't smoke.
Smoking affects how the body uses medicine, and it increases the blood's clotting effects.
- Eat a similar amount of vitamin K every day.
- Do not suddenly eat a lot more or a lot less food that is rich in vitamin K than you usually do. Vitamin K affects how warfarin works and how your blood clots.
- Foods that have a lot of vitamin K include cooked green vegetables, such as:
- Kale, spinach, turnip greens, collard greens, Swiss chard, and mustard greens.
- Brussels sprouts, broccoli, and cabbage.
- Talk with your doctor before making big changes in your diet.
- Check with your doctor before you start a diet to lose weight.
- Check with your doctor before you take any supplements or herbal products. Some may contain vitamin K.
- Limit alcohol.
It can change how warfarin works. Limit alcohol to 2 drinks a day if you are a man, or 1 drink a day if you are a woman.
- Wear medical alert jewelry.
These are bracelets, pendants, or charms that let others know you take warfarin. You can buy them at most drugstores.
- Don't take warfarin if you are pregnant or planning to get pregnant.
Talk to your doctor about how you can prevent getting pregnant while you are taking it. If you think you might be pregnant, call your doctor.
- Know when to get help for signs of bleeding.
Call 911 or other emergency services right away if:
- You have a sudden, severe headache that is different from past headaches.
- You cough up blood.
- You vomit blood or what looks like coffee grounds.
- Your stools are maroon or very bloody.
Call your doctor now or seek medical care right away if:
- You have new bruises or blood spots under your skin.
- You have a nosebleed.
- Your gums bleed when you brush your teeth.
- You have blood in your urine.
- Your stools are black.
- You have blood in your stools.
- You have vaginal bleeding that is different (heavier, more frequent, at a different time of the month) than what you are used to.
Why manage vitamin K when you take warfarin?
Warfarin is a pill that you take regularly to help prevent blood clots or to keep a clot from getting bigger. Coumadin is the common brand name for warfarin.
To make sure that warfarin is effectively thinning your blood, it's important to eat about the same amount of vitamin K every day.
Here's why:
- Vitamin K normally helps your blood clot so wounds don't bleed too much.
- Warfarin works against vitamin K. It makes your blood clot more slowly.
So warfarin and vitamin K work against each other in your body, and it's important to keep them in balance. That is why, when you take warfarin, it's important that you not suddenly eat a lot more or a lot less vitamin K-rich food than you usually do. If you do, your warfarin dose may need to be adjusted.
It's up to you to decide how much vitamin K you choose to eat. For example, if you already eat a lot of leafy green vegetables, that's fine. Just keep it about the same amount each day. And if you take a multivitamin that contains vitamin K, be sure to take it every day.
Check with your doctor before you make big changes in what you eat, such as starting a diet to lose weight. And if you want to start eating more of a food that's rich in vitamin K, talk to your doctor about how to add it safely.
Also check with your doctor before you add or change any supplements or herbal products. Some of these may contain vitamin K. If you already take a product that contains vitamin K, don't stop taking it without talking with your doctor first.
Warfarin: Why Taking It Is Worth It
Taking warfarin: When to call
Call 911 anytime you think you may need emergency care. For example, call if:
- You have a sudden, severe headache that is different from past headaches.
Call your doctor now or seek immediate medical care if:
- You have any abnormal bleeding, such as:
- Nosebleeds.
- Vaginal bleeding that is different (heavier, more frequent, at a different time of the month) than what you are used to.
- Bloody or black stools, or rectal bleeding.
- Bloody or pink urine.
Watch closely for changes in your health, and be sure to contact your doctor if you have any problems.
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