2The UCSD Anticoagulation Clinic The UCSD Anticoagulation clinic is run by pharmacistsThe 2 clinic locationsHillcrest: 330 Lewis Street 4th Ave)La Jolla: Campus Point Drive Perlman Medical offices)Contact information and important phone numbers are listed in your handout
3Warfarin / Coumadin®: What it is and What it Does What is warfarin?An anticoagulant that helps reduce the formation of clots in your bloodWhy was warfarin prescribed for you?Sometimes medical conditions can make blood clot too easily and quicklyThis could cause serious health problems because clots can block the flow of blood to the heart or brainWarfarin can prevent harmful clots from forming
4Warfarin / Coumadin®: What it is and What it Does How does warfarin work?Blood clots are formed through a series of chemical reactions in your body.Vitamin K is necessary for those reactions.Warfarin works by decreasing the activity of vitamin K which lengthens the time it takes for a clot to form
5How to Take WarfarinTake warfarin at the same time every day as directed by the Anticoagulation Clinic.Warfarin can be taken with food or other medications.If you forget a dose, take it as soon as you remember, as long as it is the same day.Never skip a dose or take a double dose.
6Blood TestsHow much warfarin you need will depend upon the results of your blood testsThe International Normalized Ratio (INR) is the blood test we will use to evaluate how long it takes your blood to clotYou will need to get your INR checked regularly as directed by the Anticoagulation Clinic
8Possible Side Effects of Warfarin Warfarin is very well toleratedMinor bleeding is the most common complication and is not dangerousGum bleedingOccasional nosebleedsEasy bruisingHeavier than normal menstrual bleedingBleeding that takes longer to stop than usualMost people will experience one or more of these effects
9Possible Side Effects of Warfarin Major bleeding is a rare but serious side effect that must be reported immediatelyRed or brown urine, red or tarry stoolsBlood in vomit or phlegm/mucusSevere headache or stomachacheProlonged or excessive bleedingLarge unexplained bruisesIf you sustain a serious fall or injury or hit your head at any time, go directly to the emergency room!
10Using Other Medications: Over-the-Counter Products Pain medicationsMedications you may useAcetaminophen (Tylenol®): no more than 2000 mg per dayMedications to avoidIbuprofen (Advil®, Motrin®, Nuprin®)Naproxen (Aleve®, Anaprox®, Naprosyn®)Aspirin (Ecotrin®, Bayer®), unless prescribed by your doctorOther products that may contain aspirin or aspirin-like products: Excedrin®, Alka-Seltzer®, Pepto-Bismol®
11Using Other Medications: Over-the-Counter Products VitaminsMulti-vitamins containing vitamin K should be taken consistentlyHerbal products to avoidDanshenGarlicGinkgoGinsengFish oilKava kavaOmega-3 fatty acidsCheck with the Anticoagulation Clinic before starting any new medication
12Using Other Medications: Prescription Medications Medications that may have a strong interaction with warfarin:Antibiotics (e.g. Septra®/Bactrim®, Flagyl®, Diflucan®)Cardiovascular medications (e.g. amiodarone)Anticonvulsants (e.g. Dilantin®, Tegretol®)Let your pharmacist or doctor know every time you start a new medication. This will allow them to evaluate whether your warfarin could interact with this new medicine.
13Diet for Warfarin Users The food you eat can affect how warfarin worksTo help warfarin work effectively, it is important to keep your vitamin K intake as consistent as possibleThe highest amount of vitamin K is found in green, leafy vegetables like broccoliAlcohol should be limited to 1 drink per dayAvoid eating mangos and liver
14How Taking Warfarin Changes Your Life Activity: Stay active, but use protection when at risk for injury.Diet: Keep it balanced and consistent. We will adjust the warfarin to your diet and lifestyle.Alcohol: Limit to 1 drink per day.Healthcare: Attend all Anticoagulation Clinic visits. Inform all healthcare providers (including us) of all medications and illnesses.Pregnancy: Do not take warfarin if you are pregnant or may become pregnant.
15Questions? Please fill out the Medical History form—front and back We will review your medicines and history and perform the INR test at your appointmentWe hope this session was informativeThanks for coming!