WARFARIN INFORMATION

You will be discharged on warfarin. Warfarin is an anticoagulant medication (“blood thinner”) that prevents your blood from clotting normally.  Warfarin is used to prevent new blood clots or treat blood clots that have already formed.

Warfarin requires monitoring of INR (blood test) on a regular basis. The most common INR goals are 2-3 or 2.5-3.5. Your specific INR goal may be different and will be set by your healthcare provider based on indication for your warfarin.  Your warfarin dose may change based on INR results upon follow-up.  

Why do I need to take warfarin?

You may need to take warfarin if you have an abnormal heart rhythm (such as atrial fibrillation), had a stroke, heart attack, valve surgery, blood clot in your lungs or extremities, or if you are at high risk for developing new clots. 

How do I take warfarin?

It is very important you take warfarin exactly as prescribed. Try to take warfarin at the same time each day, preferably in the evening. If you forget to take a dose, take it as soon as you remember. If it is less than 12 hours before your next dose, skip the missed dose. Do not take two warfarin doses at the same time. Do not stop taking warfarin, change your dose, or intentionally skip doses unless instructed to do so by your healthcare provider. 

Your warfarin dose will depend on your INR. It is very important that you follow-up on all scheduled INR appointments.  You may need to follow-up multiple times during the first several weeks after hospital discharge.  If you are not notified on the day of your INR draw with the INR result and your dosage instructions, please call your doctor's office to get this information.

Does warfarin interact with any food, medications, or procedures?

Certain foods with vitamin K may alter the effects of warfarin.  Green, leafy vegetables (examples: broccoli, spinach, kale) are some vegetables that may LOWER your INR. You may continue to eat these foods; however, it is important to keep your diet consistent.  Avoid any major changes in diet when taking warfarin.  Notify your healthcare provider before changing your eating habits.

Some medications, including over-the-counter (OTC) pain medications (such as naproxen, ibuprofen, Aleve®, Advil®, Motrin®), may increase your risk of bleeding if taken with warfarin. Other medications may affect your INR levels. Talk with your doctor or pharmacist before starting any new OTC or prescription medications, vitamins, herbal products or supplements. 

Warfarin may need to be held prior to some procedures. Tell all your healthcare providers that you take warfarin and check with all providers prior to any procedure to see if it is safe to continue warfarin. 

What adverse reactions should I be aware of?

The most common unwanted reaction seen with warfarin is an increased risk of bleeding and bruising.

You may bruise more easily, and it may take longer for any bleeding to stop. Female: You may notice heavier than normal menstrual cycles. 

To protect yourself, avoid activities that can put you at risk of falls, cuts, bruising, or bleeding.  Take extra precautions with daily activities such as shaving, brushing teeth, gardening with tools, and using knives to prepare food.

Female: If you are pregnant, considering getting pregnant, or are breast-feeding, talk with your healthcare provider about the risks and benefits of taking warfarin. 

When should I seek immediate medical attention?

Call your doctor or go to the emergency department if you:

• Have any major trauma, fall or hit to your head. Even if you feel well you should be evaluated for internal bleeding.

• Cough up blood. This may be a sign of a bleed in your lungs.

• Vomit bright red blood or what looks like coffee-grounds.  This may be a sign of a bleed in your stomach.

• Notice black tar-like stool or bright red blood with stool. This may be a sigh of a bleed in your intestines.

• Notice red, pink, or reddish-brown urine. This may be a sign of a bleed in your urinary track.

• Have bleeding from nose, gums, wound, or cut that is very heavy or will not stop even with applied pressure. Female: Have heavy uncontrolled vaginal bleeding that is not your normal.

• Feel dizzy, tired, weak or pass out without an explanation. This may be a sign of excessive blood loss.

• Have heavy pressure on your chest, difficulty breathing, or shortness of breath. This may be a sign of a clot in your lungs.

• Have sudden swelling, pain, redness, and extreme temperature change in your leg. This may be a sign of a clot in your leg.