Warfarin Counseling. Clinic Patient Education

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1 Warfarin Counseling Clinic Patient Education

2 The UCSD Anticoagulation Clinic The UCSD Anticoagulation clinic is run by pharmacists The 2 clinic locations Hillcrest: 330 Lewis Street (@ 4 th Ave) La Jolla: 8939 Villa La Jolla Drive (@ La Jolla Village Drive) Contact information and important phone numbers are listed in your handout

3 Warfarin / Coumadin : What it is and What it Does What is warfarin? An anticoagulant that helps reduce the formation of clots in your blood Why was warfarin prescribed for you? Sometimes medical conditions can make blood clot too easily and quickly This could cause serious health problems because clots can block the flow of blood to the heart or brain Warfarin can prevent harmful clots from forming

4 Warfarin / 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

5 How to Take Warfarin Take 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.

6 Blood Tests How much warfarin you need will depend upon the results of your blood tests The International Normalized Ratio (INR) is the blood test we will use to evaluate how long it takes your blood to clot You will need to get your INR checked regularly as directed by the Anticoagulation Clinic

7 Blood Tests

8 Possible Side Effects of Warfarin Warfarin is very well tolerated Minor bleeding is the most common complication and is not dangerous Gum bleeding Occasional nosebleeds Easy bruising Heavier than normal menstrual bleeding Bleeding that takes longer to stop than usual Most people will experience one or more of these effects

9 Possible Side Effects of Warfarin Major bleeding is a rare but serious side effect that must be reported immediately Red or brown urine, red or tarry stools Blood in vomit or phlegm/mucus Severe headache or stomachache Prolonged or excessive bleeding Large unexplained bruises If you sustain a serious fall or injury or hit your head at any time, go directly to the emergency room!

10 Using Other Medications: Over-the-Counter Products Pain medications Medications you may use Acetaminophen (Tylenol ): no more than 2000 mg per day Medications to avoid Ibuprofen (Advil, Motrin, Nuprin ) Naproxen (Aleve, Anaprox, Naprosyn ) Aspirin (Ecotrin, Bayer ), unless prescribed by your doctor Other products that may contain aspirin or aspirin-like products: Excedrin, Alka-Seltzer, Pepto-Bismol

11 Using Other Medications: Over-the-Counter Products Vitamins Multi-vitamins containing vitamin K should be taken consistently Herbal products to avoid Danshen Garlic Ginkgo Ginseng Fish oil Kava kava Omega-3 fatty acids Check with the Anticoagulation Clinic before starting any new medication

12 Using 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.

13 Diet for Warfarin Users The food you eat can affect how warfarin works To help warfarin work effectively, it is important to keep your vitamin K intake as consistent as possible The highest amount of vitamin K is found in green, leafy vegetables like broccoli Alcohol should be limited to 1 drink per day Avoid eating mangos and liver

14 How 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.

15 Questions? Please fill out the Medical History form front and back We will review your medicines and history and perform the INR test at your appointment We hope this session was informative Thanks for coming!

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