Then there's the elephant in the room that is warfarin. You've read all you can about Eliquis and Xarelto and Pradaxa (oh my!). Staying in range on warfarin is vital in ensuring that the medication is working for you and also in avoiding serious bleeding complications.Steph and Brandon’s Note: Imagine it's your first week of an APPE rotation at an anticoagulation clinic. Dietary concerns are especially important at times like travel, when you may be eating differently than you normally do at home. In other words, do not binge on a salad-only diet for 2 weeks, then not eat green leafy vegetables at all for a month. Our general philosophy is not to eliminate these foods entirely from your diet, but to be aware of them and to eat a consistent amount of them every day. Some foods contain a lot of Vitamin K and will alter your coumadin levels. If you are anticipating any type of procedure, even dental work or an epidural, be sure to alert your treating physician and the person monitoring your coumadin. Take your warfarin at the same time every day. Get your protime checked in the morning, so that results from the blood test are available before the close of the day.Ĩ. Avoid high-risk activities, such as high contact sports, boxing, sky diving.ħ. Limit the use of other medications that thin your blood while you are on warfarin. Take acetaminophen rather than ibuprofen, if you can. If you develop spontaneous bleeding (prolonged nosebleed or bleeding from the rectum), or if you are in a major accident or suffer head injury while on warfarin, seek medical attention. For example, many antibiotics interact with warfarin, and your protime may need to be checked more closely while you are on these medications.Ĥ. Any time a new medication is added to your regimin, ask your pharmacist or physician about potential interactions with warfarin. This may be important if you are in an accident.ģ. Carry a card in your wallet or a bracelet on your wrist stating that you are on warfarin. Talk with your doctor if you are planning to radically change your diet or if your weight has changed significantly.Ģ. They are not yet FDA approved for all applications, but are used in some patients who cannot take warfarin.ġ.
There are other newer oral anticoagulants which are currently being studied as alternatives to warfarin (Arixtra, Xarelto, Pradaxa). If you develop uncontrolled bleeding on warfarin, or if you are involved in a major trauma or suffer a head injury while taking this medication, you should seek immediate medical attention. The chances of developing this complication is mitigated by use of Lovenox to bridge the coumadin.
#INR NORMAL RANGE LOVENOX SKIN#
Rarely, starting warfarin is associated with painful red or black sores in the skin of the legs, buttock or breasts which can lead to large open wounds (warfarin necrosis). Side effects of warfarin include bleeding problems, rash or hives, easy bruising, nausea, flu like symptoms/fatigue, joint or muscle aches, diarrhea, gas, hair loss, and change in the sensation of taste. If you are working with our office to monitor your warfarin, please make sure we have a reliable way to reach you on the days you have your INR drawn. That way, your lab results are available by the afternoon, so that we can adjust your level if we need to.
Always take your warfarin at night and always have the INR drawn in the morning. If you are going to be on warfarin for a while, sometimes purchasing a home monitor and doing the blood test yourself at home is a good option. Typically, you identify a lab near you where your "standing order" for the INR is kept. Once you reach a stable level of warfarin, it is checked less frequently (once or twice a month). When you first start warfarin, the INR may need to be checked every day or every other day. It may also be used at times when your INR drifts too low. This medication is administered by you or your family twice a day and is continued until the warfarin level is theraputic. During the initial start-up time, you are also started on or "bridged" with an injectable medication called Lovenox (Enoxaparin). The level in your blood stream is monitored with a blood test called protime (PT) or international ratio (INR). When you first start warfarin, it typically takes several days for the medication to take effect. This decision may be made in concert with your vascular surgeon, primary care physician, hematologist and cardiologist. Some people require warfarin for only a few months others need lifelong treatment. The length of time you are on warfarin varies patient to patient.
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