This blog is purely informational and does not now or will not ever replace your doctor’s vast knowledge and awareness of what is best for you. Any question you may have about the use, dosage, side effects or other concerns should be addressed with your doctor as soon as possible.
What is Coumadin? Coumadin is prescription medicine used to treat blood clots and to lower the chance of blood clots forming in your body. Blood clots can cause stroke, heart attack or other serious conditions if they form in the leg or lungs. You may feel overwhelmed with all the “restriction”, precautions, signs or symptoms of Coumadin toxicity. So, let us peel back the layers one by one to help you understand a little more.
Most importantly Coumadin can cause bleeding which can be serious and sometimes lead to death. As previously mentioned, the purpose of this medication is to help prevent blood clots by thinning out the blood, and decrease risk for blood clots. So, who is in the higher risk factors for bleeding if you take Coumadin? People 65 or older, those who have a history of stomach or intestinal bleeding, have high blood pressure (hypertension), have a history of a stroke, or a mini stroke (TIA), have serious heart disease, have a low blood count or cancer, have had a trauma, such and accident or surgery, have frequent falls, have kidney problems, take other medications that increase your risk of bleeding, including…a medicine that contains heparin, other medicines to prevent or treat blood clots, nonsteroidal anti-inflammatory drugs (NSAIDS) or take warfarin sodium for a long time as Warfarin sodium is the active ingredient in Coumadin. There are many other medications that interact with Coumadin so always have a list of your medications when going to ALL of your doctor appointment so they can make the best recommendations based off of all of your medications.
If you or a loved one start on Coumadin there is a required test to check your response to Coumadin. This blood test is called an INR test. The INR test checks to see how fast your blood clots. Your healthcare provider will decide what INR numbers are best for you. Your Coumadin dosage will be adjusted to keep your INR in a target range for you. There are many different dosages out there that can be combined by your health care provider in different way. The pills come in 1 mg,2 mg,2.5 mg,3 mg,4 mg,5 mg,6 mg,7.5 mg, and 10 mg strengths. Each pill is marked clearly with COUMADIN name and dosage strength, to prevent confusion with other medications and to ensure you have the right dosage. Each pill is scored so it can be easily broken in half.
What do I need to look out for, you know side effects? It is recommended that you call your healthcare provider immediately if you have signs or symptoms of bleeding problems: pain, swelling, or discomfort, headaches, dizziness, or weakness, unusual bruising (bruises that develop without known cause or grow in size), nosebleeds, bleeding gums, bleeding from cuts that takes a long time to stop, menstrual bleeding or vaginal bleeding that is heavier than normal, pink or brown urine, red or black stools, coughing up blood, and vomiting blood or material that looks like coffee grounds. Any one of these could be signs of bleeding problems.
Now it’s time to tackle some of the most common questions before we wrap up.
HOW DOES COUMADIN WORK?
Your liver makes clotting factors that help for blood clots and prevent bleeding. When you get a cut this is how your body would naturally stop the bleeding. Some blood clots however can cause serious medical problems. Coumadin blocks the formation of these clotting factors, lowering the chance of blood clots developing in your body.
HOW OFTEN DO I HAVE MY BLOOD TESTED?
Initially, your doctor may perform daily blood tests until your INR range stabilizes. After the INR is stabilized at the level determined by your doctor, additional blood tests may be performed every 1 to 4 weeks. Your INR should also be determined prior to ANY DENTAL OR SURGICAL PROCEDURE, and whenever any other medications are started.
WHAT ARE SOME THINGS THAT CAN MAKE MY INR RESULTS CHANGE?
Some prescription and over-the-counter drugs, as well as certain foods and herbal products, can increase or decrease your ability to clot, which directly effects your bloods ability to clot. This is why it is imperative that your doctor have an actual working list of any medication or supplement you are taking to make sure your dosage is correct. Just for a quick example regarding herbal products…some will increase the effects of Coumadin such as garlic and gingko. Yet others will decrease the effects such as St. John’s wort, co-enzyme Q10 and ginseng. Your doctor’s opinion of the supplements is not what you are necessarily concerned with but it makes their job easier and safer for you, so let them know.
IF MY HEALTHCARE PROVIDER TELLS ME TO STOP TAKING COUMADIN, HOW LONG WILL THE BLOOD THINNING EFFECT LAST?
The anti-clotting effect may last for about 2 to 5 more days.
DO I HAVE TO PAY ATTENTION TO MY DIET?
Too much vitamin K can lower the effect of Coumadin, so it is important to keep your vitamin K intake as consistent as possible. Sudden increases or decreases may affect your response to Coumadin.
HOW DO I KNOW HOW MUCH VITAMIN K IS IN THE FOOD I EAT?
Probably the most common question people ask or get confused about is…What can I eat? Well it is recommended that you eat a normal balanced diet and talk to your healthcare provider before making any diet changes. Do not eat large amounts of leafy green vegetables, which contain vitamin K. Certain vegetables oils also contain large amounts of vitamin K. Too much vitamin K can lower the effects of Coumadin. So how much vitamin K per day is recommended? According to the U.S. Food and Drug Administration you should intake 80 micrograms of vitamin K, based on a 2000-calorie diet. The amount you consume from day to day may vary; it may be higher or lower than the recommended 80 micrograms. If you would like to know exactly how much vitamin K is in the food you are eating you can go to www.usda.gov and search the National Nutrient Database for Standard Reference. Just remember to be as consistent as possible with what you eat and this above list will help you to do that.
Many people feel like living and taking Coumadin are not easy to do. It is true when first starting Coumadin it can be a challenge and making changes possibly to your lifestyle is never easy. With the help of your physician and pharmacist you will be able to get through that rough patch before you know it!! Everyone I have met on Coumadin lives a normal life in which Coumadin does not drastically effect. One recommendation that you should always keep in mind, if you or your loved one on Coumadin fall and hit your head, contact your physician immediately as further medical treatment may be needed. All of this information and more can be found at www.COUMADIN.com .