UP Health System - Marquette - Coumadin Clinic
Oral anticoagulants have been the foundation of long-term treatment and prevention of blood clots for more than sixty years. Anticoagulation means, “Any agent used to prevent the formation of blood clots.” Many people interchange the term “anticoagulation” with the expression "thinning of the blood." Anticoagulant medicines are usually known as blood thinners. However, anticoagulants do not really thin, dissolve, or dilute blood. They have the ability to decrease blood clotting, reducing the risk of certain medical conditions.
Warfarin (also known by the trade name of Coumadin®) is an oral anticoagulant that is widely used in the United States. Millions of people have safely and effectively used warfarin to prevent strokes, leg clots (deep venous thrombosis), lung clots (pulmonary emboli), and other disorders. However, due to its unique action on reducing blood clots, higher levels of warfarin in the blood can increase the risk of bleeding. Warfarin requires a regular laboratory test: international normalized ratio [INR]. This blood test measures warfarin’s effect on the body’s ability to form clots. Various things can interfere with warfarin’s effect in the body, including medicines, food, and illnesses. As a result, warfarin requires careful dosing, monitoring, and follow-up. This medicine must be taken with great care. It is important to follow the rules to maximize the benefits and minimize the potential side effects.
There are newer anticoagulants available that also prevent/treat clots and strokes. These agents include: Pradaxa®, Xarelto®, and Eliquis®. These medicines have the same action on reducing blood clots as warfarin, but they do not require blood tests. However, these medicines are much more expensive than warfarin.
The key to success with warfarin management is education. Patients who understand the reasons for taking warfarin and having it monitored closely are successful in their long-term therapy.
THE MOST IMPORTANT POINTS
· Always know what your current dose is.
· You should seek immediate medical attention if you bump your head while on Coumadin.
· You should seek immediate medical attention if you are bleeding for longer than 20 minutes.
· Never take a double dose or skip a dose of this medicine unless directed by your doctor or nurse.
· Remind anyone who prescribes medicine for you that you are using warfarin. This will help avoid unsafe interactions with other medicines.
· Report any unusual bleeding (it doesn't need to be a lot . . . it is simply important that it is occurring "for no good reason").
· Don’t miss your blood testing appointments!
· Diet changes can alter warfarin's effect.
· Warfarin comes in many tablet strengths. Make sure you are taking the right size pill. If you have trouble with this (for example, poor vision), have someone help you with your pills.
· Discuss the use of aspirin and acetaminophen (Tylenol®) with your doctor . . . in general, aspirin should not be used unless specifically prescribed, and acetaminophen should be used in only small quantities.
· Consult with a physician or pharmacist before taking any over-the-counter or herbal medicines while you are on warfarin, since many can interact.
· Call your physician with any questions immediately
· Consider obtaining a "Medic Alert" or similar bracelet stating that you are on warfarin.