What is warfarin?

• Warfarin is an anticoagulant  (anti = against, coagulant = clotting)
• Warfarin is strong medicine that slows your body’s ability to form a blood clot
• Some people call warfarin a "blood thinner” 
• Warfarin is also known as CoumadinÒ, CoumadinÒ is the brand name for warfarin
• Generic warfarin is made by several different companies – take only as prescribed

How do I take warfarin?

• Take your warfarin only as directed by your doctor or pharmacist
• Try to take your warfarin at the same time everyday
• Do not take more than prescribed as it could cause bleeding 

Why do I need my blood tested?

• Blood tests called INRs tell your doctor just how much medicine is working
• Blood tests will be needed for as long as you are on warfarin
• Other medications and food will change the results of your INR frequently
• The doctor will try to get your INR in a “target range”

What is an INR?

• The INR is the name given to the results of your blood test
• The INR will be a number like:  1.7   or   2.0   or   2.6   or   3.8   or   5.8
• The higher the number, the longer it will take your blood to clot
• Your doctor will tell you where your INR needs to be
• An INR “target range” will be made for you
• An INR too high increases your chances of bleeding
• An INR too low does not protect you from bad blood clots that might form

Is my diet important?

• Consistency in your diet and steady portion sizes is most important
• Many foods can change your INR
• Vitamin K is an important vitamin to learn about
• Vitamin K slows or can stop warfarin from doing its job
• Vitamin K is found in leafy green vegetables and other foods and teas
• Ask your health care professional team if you are unsure of a certain food type 

What do I do if I miss a dose?

• Warfarin is a strong medicine that lasts for days, check with your doctor’s office if you miss a dose – if it is only a few hours it is likely you will take it as soon as you remember
• Don’t panic, missing a dose is not life-threatening but getting back on schedule is important
• Never take an extra warfarin tablet to catch up unless instructed by your doctor or nurse

What are signs of trouble?

• Bleeding gums, blood in your urine, black or tarry stools are signs of too much warfarin
• Unusual or excessive bruising is a sign of too much warfarin
• A high INR, well outside your target range places you at risk of bleeding

What else do I need to know?

• Report to all your blood test appointments and office visits
• Check before starting or stopping ANY vitamins or nutritional drinks
• Report any fevers, bad colds or flu as this will affect your INR
• Report any bumps, bruises or cuts as warfarin will make it bleed longer
• Many over-the-counter medicines can affect your INR – including stomach medicines, calcium supplements and cold & flu medicines to name just a few
• Keep your doctor’s office phone number with you and by the phone

Do’s

• Talk to your office about any concerns or questions regarding your warfarin %
• Remain consistent in your diet and portion sizes of fruits and vegetables
• Talk to your doctor or nurse before starting or stopping any medicine
• Wear gardening gloves and closed toe footwear when working outside
• Place knives and forks point down in the dishwasher
• Consider a life-line pendant if you live alone
• Consider a bracelet that lets emergency personnel know you are on CoumadinÒ
• Clear stairways of books, papers, shoes or other clutter
• Use nightlights to illuminate walkways to bathrooms
• Use handrails and contact tape on all tubs and showers
• Use soft bristled tooth brushes
• Use pillboxes, it is very easy to forget if you took your tablet or not
• Use electric razors for shaving
• If you test at home weekly, call in your INR as instructed

Don’ts

• Don’t run out of medicine
• Don’t miss lab appointments or doctor’s visits
• Don’t reach in or push the garbage down
• Don’t binge on any fruit or vegetable
• Don’t drink excessive alcohol with warfarin
• Don’t reach into soapy water in the sink where silverware and dishes soak 
• Don’t wear footwear that is wet on hardwood or linoleum floors
• Don’t guess whether you took your warfarin, make sure you don’t double up
• Don’t forget changes in dose or diet takes days to change your INR

_{^{CoumadinÒ is a registered trademark of the Bristol-Myers Squibb Co.}}