TIP OF THE WEEK

Patient Education: Coumadin®/warfarin and What it Does for You

 

Coumadin®/warfarin is an anticoagulant or “blood thinner” that makes a person’s blood less likely to clot by impairing the clotting process (“Anti” – against; “coagulant” - to thicken into a gel or solid). Use the basic information below to educate your patients about the medication.

 

TAKING COUMADIN/WARFARIN

Always take your pills as directed. You must take the pills only on the days your doctor tells you to. The amount of Coumadin/warfarin each person needs is different. The dose is based on a blood test called the Prothrombin time (or Protime) expressed as an International Normalized Ratio (INR). The amount of medication you take may change, based on the blood test. It needs to be taken at the same time, usually in the evening.

 

CHECKLIST:

• Go for blood test as directed
• Never skip a dose
• Never take a double dose
• Take Coumadin/warfarin in the evening at the same time as directed by your doctor

BLOOD TEST

The test measures how fast your blood is clotting and lets the doctor know if your dosage should change. If your blood test results are too high, you might be at risk for bleeding problems. If the results are too low, you might be at risk for forming clots.

Your doctor decides on a range that is right for you. Getting your blood within the target range is getting it balanced. When you first start taking Coumadin/warfarin you may have your blood checked often. Once the blood test is in the target range and the correct dose is reached, this test is done less often. Because your dose is based on the INR blood test it is very important that you get your blood tested on the date and at the time that you are told.

 

POSSIBLE SIDE EFFECTS

Most side effects relate to how the medicine works. Even when your INR blood test is in range, you might see:

• Bruises
• Slight gum bleeding
• Hair loss (rare)
• Skin rashes (rare)
• Occasional nose bleed
• Bleeding after a minor cut that stops within a few minutes
• Menstrual bleeding that is a little heavier than normal

POSSIBLE COMPLICATIONS

Call your doctor or go to the hospital emergency room right away if you have any of the following:

• Red, dark, coffee, or cola colored urine
• Bowel movements that are red or look like tar
• Bleeding from the gums or nose that does not stop quickly
• Vomit that is coffee colored or bright red
• Anything red in color that you cough up
• Severe pain, such as a headache or stomachache
• Sudden appearance of bruises for no reason
• Menstrual bleeding that is much heavier than normal
• A cut that will not stop bleeding within 10 minutes
• A serious fall or hit on the head
• Dizziness or weakness

BE CAREFUL

You will need to be careful using objects that could make you bleed, such as knives, razors and scissors. It is very important to know that you can be bleeding and not see any blood (i.e., head injury that causes bleeding under the skull). Call your doctor or go to the hospital immediately if you have taken a bad fall, even if you are not bleeding. Also, talk to your doctor about wearing a medical alert bracelet or necklace. If you are badly injured and unable to speak, the bracelet would tell healthcare workers that you are on Coumadin/warfarin.

 

PREVENT INJURY

It is important that everyone, but especially those on Coumadin/warfarin, take measures to keep themselves safe. Below are some basic things you can do to prevent injury and bleeding:

• Be very careful using knives and scissors
• Use an electric razor
• Use a soft toothbrush
• Use waxed dental floss
• Do not use toothpicks
• Wear shoes or non-skid slippers in the house
• Take care trimming your toenails
• Do not trim corns or calluses yourself
• Always wear shoes
• Be very careful with sharp tools; wear gloves when using them
• Avoid activities and sports that can easily hurt you
• Wear gardening gloves when doing yard work
• Stay active

 

Source:

Your Guide to Coumadin/Warfarin Therapy, Agency for Healthcare Research and Quality. http://www.ahrq.gov/consumer/coumadin.htm, last accessed 6/18/08.

 

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