Why do I need warfarin (Coumadin)?
Your doctor will prescribe warfarin (Coumadin) for you because your body may make clots where it is not supposed to. These clots can cause serious medical problems. For example, a clot can move to another part of your body, such as the brain and cause a stroke.

Warfarin (Coumadin) is used to treat blood clots in the legs, lungs, or other parts of the body. Warfarin is also used to prevent blood clots in people with an irregular, rapid heartbeat (atrial fibrillation), and heart-valve replacements.

If you've had a heart attack, warfarin (Coumadin) may be used to lower your risk of death, another heart attack, stroke, or the risk of blood clots moving to other parts of the body.

How do I take Coumadin?
You doctor or pharmacist will determine how much warfarin (Coumadin) your body may need by doing blood tests. This test is called an INR. At St. Rita's Center for Disease Management, blood tests are done regularly to determine how long it takes the patient's blood to clot. On-site laboratory services make it convenient for patients to have their blood drawn and tested. At each visit, patients discuss with their pharmacist how they take their warfarin and talk about other medication questions or health concerns.

Pharmacists at the Center can also make dosage adjustments to the patient's warfarin (Coumadin) therapy based on the results of their blood tests. They also carefully monitor the addition of other medicines the patient may be taking for possible drug interactions. Pharmacists contact the patient's doctor if changes in medications should be considered. A physician's referral is required to be enrolled in the clinic.

Try to take your Coumadin at the same time every day and take it exactly the way that your healthcare provider has recommended. If you forget to take a pill, contact your physician and take the missed dose as soon as possible that same day. Do not take a double dose to make up for a missed dose the next day.

What are the possible side effects of warfarin (Coumadin)?
The most common side effect of warfarin (Coumadin) is bleeding. Many things including travel, changes in diet, environment, general health and medications including herbs may change the way the body responds to warfarin (Coumadin). To lower the risk of bleeding, your blood tests should be kept within a range that is right for you. Please contact your healthcare provider right away if you experience signs or symptoms of bleeding such as:

Rare side effects of warfarin (Coumadin) include death of skin tissue and purplish toes. Talk with your healthcare provider for further information on these side effects.

What should I know about drug interactions and diet?
Warfarin (Coumadin) interacts with many medicines, including prescription and non-prescription (over-the-counter) drugs. For this reason, it is important for you to check with your physician or pharmacist before starting, changing or stopping any medicine. Some of the over-the-counter medicines that may interact with warfarin (Coumadin) include: aspirin, ibuprofen (Advil), naproxen (Aleve) and vitamin supplements. Other medicines may change your response to warfarin (Coumadin). Please check with your healthcare provider for additional information.

Herbal medications may also interact with warfarin (Coumadin). You should know that most herbal preparations are not standardized and the same amount may not be contained in each pill. Talk to your doctor or pharmacist if you take herbal and/or natural products since some of them do not mix well with warfarin (Coumadin) and you may need to be monitored more closely.

What should I be careful NOT to do?
Do not take extra warfarin (Coumadin) pills to catch up. If you forget to take a tablet, tell your doctor or pharmacist. Take the missed dose as soon as possible on the same day, but do not take a double dose of Coumadin the next day to make up for the missed dose.

Do not take Coumadin if you are pregnant or may become pregnant.

Do not take any other medications before asking your doctor or pharmacist.

Be aware that Coumadin and generic warfarin tablets are the same medicine and should not be taken together. An overdosage may result.

What should I avoid?
Avoid drastic changes in your dietary habits.

Avoid alcohol consumption.

Avoid any activity or sport that may result in traumatic injury.

Avoid grapefruit and grapefruit juice.

Avoid using a new over-the-counter or prescription medicine without notifying your doctor or pharmacist.