Coumadin®: Cruisin' for a Bruisin'
  Contributed by: Cody Poell, Pharm.D. Candidate
                        KU School of Pharmacy

What is Coumadin®?
Coumadin® is an anticoagulant, which means it helps keep clots from forming in your blood.  It is used to help prevent clots associated with a-fib (rapid,irregular heartbeat), heart valve replacement, and from clots forming in the legs and lungs.  The generic name of Coumadin® is Warfarin.

How does Coumadin® work?
Coumadin®blocks vitamin K dependent clotting factors from being made in your liver.  It keeps clots from both forming and getting bigger, it does not break up clots that are already formed.  Coumadin® does not begin working right away, it takes 3-4 days to see the full effect.

How do I take my Coumadin®?
Take your Coumadin® at the same time every day.  Do not double up your dose if you miss a dose.  Your dosage will be determined by a PT/INR blood test.  This test helps see how fast your blood is clotting and whether your Coumadin® dosage should change.  When you start Coumadin®, you might have a PT/INR test every couple of days, then maybe once a week, and eventually every 3-4 weeks to keep your PT/INR in the correct range for your medical condition.  Your dosage may change every once in a while depending on your PT/INR value, and you may be taking different dosages on different days.  Therefore, it is important you make sure you are taking the

correct dose on the correct day.

What are some possible side effects of Coumadin®?
Side effects associated with Coumadin® include nosebleeds, bleeding of gums while brushing teeth, blood in urine, red or black stools, vomiting blood, and unusual bruising (bruise grows larger and doesn't heal well). 

What about drug interactions with Coumadin®?
Coumadin® has many drug interactions associated with it.  Check with your physician or pharmacist before beginning any new medicine, both prescription and nonprescription.  Some nonprescription drugs that interact include aspirin, ibuprofen, naproxen, and vitamin supplements that have Vitamin K in them.  Also, many herbal medicines can interact with Coumadin®

Why is diet important with Coumadin®?
Changes in the amount of Vitamin K intake alters the way Coumadin® works.  Vitamin K helps the blood clot, so an inconsistent intake of Vitamin K can lead to inconsistent PT/INR values.  Foods that contain high vitamin K content are typically leafy green vegetables like spinach and broccoli.  Don't avoid eating these foods, just eat them on a consistent basis.

Things to do while on Coumadin®:

  • Take your Coumadin® around the

same time every day, typically at nighttime

  • Get your blood tested on schedule
  • Tell your physician or pharmacist about any new medications (prescription, OTC, herbal)
  • Keep eating habits consistent
  • Tell your physician about any unusual bruising or bleeding
  • Tell anybody giving you medical or dental care that you are taking Coumadin®
  • Wear a medical bracelet or have an ID card that says you are taking Coumadin®

Things not to do on Coumadin®:
  • Don't double up a dose of Coumadin® if you forgot the previous days dose
  • Don't take other medications without consulting your physician or pharmacist
  • Don't take Coumadin® if you are pregnant

For additional information talk with your pharmacist or physician, or visit www.coumadin.com.

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