Lake Champlain Cardiology Associates
52 Tom Miller Rd., Plattsburgh, NY 12901  (518) 563-2404
www.lccahearts.com

Coumadin/Warfarin Guidelines

What is Coumadin (warfarin)?
Coumadin is an anticoagulant (blood thinner) – helps reduce clots from forming in the blood.
Coumadin is used to help prevent and treat blood clots:

1. in the legs and lungs
2. associated with an irregular, rapid heartbeat (atrial fibrillation)
3. associated with artificial heart valves

Side Effects

1. Bleeding from shaving or other cuts that does not stop
2. Nosebleeds
3. Bleeding of gums when brushing your teeth
4. Throwing up blood
5. Unusual bruising (black and blue marks on your skin) for unknown reasons
6. Red or dark brown urine
7. Red or black color in your stool
8. More bleeding than usual when you get your menstrual period or unexpected bleeding from the vagina
9. Unusual pain or swelling

Coumadin Guidelines
Your doctor determines how much Coumadin you need to take by giving you blood tests.  These blood tests are called prothrombin time (PT) or International Normalized Ratio (INR) and measure how fast your blood is clotting. 

1. Your dosage may change according to results of your blood test, so make sure you keep track of your dosage.
2. Coumadin should be taken at dinner time (between 5-6pm) each day.
3. When you start taking Coumadin, you may have PT/INR tests every few days, then less frequently as instructed. 
4. Periodic bloodwork will be needed throughout your course of therapy to help keep your PT/INR in the best range for your medical condition. 
5. Many things can affect your results – sickness, diet, travel, vitamins, medications – notify your doctor if any changes occur.
6. Always notify your doctor before starting, changing or stopping any medication.
7. Notify your doctor if you get sick, hurt, or get a cut that won’t stop bleeding.
8. Notify all of your doctors (including dentist) that you are on Coumadin.
9. Medication refills for Coumadin will be refilled by the doctor who is monitoring your Coumadin.
10. Never double up on your Coumadin dose if you have missed a dose – contact your doctor first.
11. Avoid alcohol consumption.
12. Avoid any activity that may result in traumatic injury.
13. Avoid drastic changes in your diet.
14. Your blood can remain thin 2-5 days after stopping Coumadin.
15. FOOD INTERACTIONS: Many foods you eat have Vitamin K in them.  Vitamin K helps your blood clot.  Eating foods with Vitamin K will decrease the effectiveness of Coumadin.
1. It is important for you to keep your diet consistent so the amount of Vitamin K you eat is consistent.