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Discharge Instructions: Taking Coumadin (Warfarin)

Coumadin (warfarin) helps prevent blood from clotting. But it also increases your risk for bleeding. Because of this, it must be taken exactly as directed.

Guidelines for Medication Use

  • Follow the fact sheet that came with your medication. It tells you when and how to take your medication. Ask for a sheet if you didn’t get one.

  • Do not take Coumadin during pregnancy because it can cause birth defects. Talk to your doctor about the risks of taking Coumadin while pregnant.

  • Take Coumadin at the same time each day.

  • If you miss a dose, take it as soon as you remember—unless it’s almost time for your next dose. In that case, skip the dose you missed. Don’t take a double dose.

  • Keep appointments for blood (protime/INR) tests as often as directed. Diet and medications can affect your protime/INR level.

  • Don’t take any other medications without checking with your doctor first. This includes over-the-counter medications, herbal remedies, and supplements.

  • Tell all doctors, dentists, and other healthcare providers you see that you take Coumadin.

  • Avoid having any injections while taking this medication.

Other Precautions

  • Carry a medical identification card or wear a medical ID bracelet that says you take this medication.

  • Use a soft toothbrush and an electric razor.

  • Don’t go barefoot. Don’t trim corns or calluses yourself.

  • Protect yourself from any injury that could lead to bleeding. Avoid contact sports or any other activity where injury is likely.

Keep Your Diet Steady

Keep your diet pretty much the same each day. That’s because many foods contain vitamin K. Vitamin K helps your blood clot. So eating foods that contain vitamin K can affect the way Coumadin works. You don’t need to avoid foods that have vitamin K. But you do need to keep the amount of them you eat steady (about the same day to day). If you change your diet for any reason, such as due to illness or to lose weight, be sure to tell your doctor.

  • Examples of foods high in vitamin K are asparagus, avocado, broccoli, and cabbage. Oils, such as soybean, canola, and olive oils, are also high in vitamin K.

  • Other food products can affect the way Coumadin works in your body:

    • Food products that may affect blood clotting include cranberries and cranberry juice, fish oil supplements, garlic, ginger, licorice, and turmeric.

    • Herbs used in herbal teas or supplements can also affect blood clotting. Keep the amount of herbal teas and supplements you use steady.

    • Alcohol can increase the effect of Coumadin in your body.

Talk with your healthcare provider if you have concerns about these or other food products and their effects on Coumadin.

Possible Side Effects

Tell your doctor if you have any of these side effects. However, do not stop taking your medication unless your doctor tells you to stop. Side effects may include:

  • More gas (flatulence) than usual

  • Orange-colored urine

  • Bloating

  • Diarrhea

  • Nausea

  • Vomiting

  • Hair loss

  • Decreased appetite

  • Weight loss

When to Call Your Doctor

Call your doctor right away if you have any of the following:

  • Trouble breathing

  • Swollen lips, tongue, throat, or face

  • Hives or painful rash

  • Black, bloody, or tarry stools

  • Blood in your urine

  • Vomiting or coughing up blood

  • Bleeding gums or sores in your mouth

  • Unusual bleeding or bruising, including heavy menstrual periods

  • Urinating less than usual

  • Yellowing of the skin or eyes (jaundice)

  • Dizziness

  • Severe headache

  • Purple discoloration of your toes or fingers

  • Sudden leg or foot pain

  • Chest pain

  • Confusion

  • Slurred speech

  • Weakness on one side of the body


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