Saturday, February 03, 2007
Coumarines
Warfarin, which goes by the brand name Coumadin, is an anticoagulant medication. This means that it helps prevent clots from forming in the blood. You have been prescribed warfarin because your body may be making blood clots or you may have a medical condition known to promote unwanted blood clots. It is often prescribed for patients with atrial fibrillation (an irregular heart rhythm), pulmonary embolism, and after artificial heart valve surgery or orthopedic procedures.
Blood clots can move to other parts of your body and cause serious medical problems, such as a heart attack. Warfarinwill not dissolve a blood clot; however, over time, the blood clot may dissolve on its own. Warfarin may also prevent other clots from forming or prevent clots from becoming larger. Warfarin will not dissolve a blood clot, but it may prevent other clots from forming and keep existing clots from getting larger. There are other blood thinners that you may be given in the hospital or even at home for a short amount of time: Heparin, Lovenox, or Fragmin. These drugs are administered either by vein (intravenous) or just under the skin into the subcutaneous fat.
Blood testing
In order for your health care provider to determine the correct dose of warfarin, it will be necessary for you to have blood tests. The tests are performed in a laboratory, usually once a week to once a month, as directed by your doctor. The prothrombin time (PT or protime) test is used to calculate your International Normalized Ration (INR). Your INR will help your health care provider determine how fast your blood is clotting and whether your medication dose needs to be changed. Illness, diet, medication changes and physical activities may affect your INR. Tell your health care provider about changes in your health, medications (prescription and over-the-counter) or lifestyle so appropriate dosage adjustments can be made in your warfarin therapy.
What does warfarin look like?
Coumadin brand tablets are round and scored, which means they can be broken in half. Each tablet color represents a different strength. The strength of the tablet is measured in milligrams (mg) as follows:
1 mg (pink)
2 mg (lavender)
2.5 mg (green)
3 mg (tan)
4 mg (blue)
5 mg (peach)
6 mg (teal or blue-green)
7.5 mg (yellow)
10 mg (white)
Other brands of warfarin should have the same colors and strengths as the Coumadin brand tablets. However, other brands of warfarin tablets may have a different shape or appearance. For example, they may be oval or square.
How should I take warfarin?
Take your warfarin dose as instructed once a day. Try to take it at the same time every day. A good time to take your warfarin is early in the evening (such as between 5 and 6 p.m.). Warfarin can be taken with or without food. Do not take a double dose to make up for a missed dose. Also, never change your dose without first discussing the change with your doctor.
How should I store warfarin?
As with any medication, store your warfarin at room temperature, away from extreme cold, heat, light or moisture. Bathroom cabinets are usually NOT suitable for storing medications because of the dampness. All medications, including warfarin, should always be kept out of the reach of children and pets.
What precautions should I take?
It is important that you follow these precautions when taking warfarin to reduce the risk of side effects and improve the effectiveness of your medication.
Medications and Dietary Supplements
Many medications and dietary supplements can affect the way warfarin works. These may include:
Prescription medications
Nonprescription medications such as aspirin, nonsteroidal anti-inflammatory drugs or NSAIDs (some examples are ibuprofen, naproxen or ketoprofen), cough or cold remedies and medications for pain or discomfort
Herbal products, natural remedies or nutritional supplements
Products containing vitamin K
Before taking any new medication, including over-the-counter medications, herbal products, vitamins, nutrition supplements, or medication prescribed by another doctor or dentist, check with the doctor who monitors your warfarin medication. Your warfarin doctor may need to adjust your warfarin dosage or may recommend another medication less likely to interfere with warfarin.
Diet
Eat a sensible, well-balanced diet.
Talk with your doctor if you are planning any major dietary changes such as following a weight-reducing diet or adding nutritional supplements.
Large amounts of food high in vitamin K (such as broccoli, spinach and turnip greens) may change the way warfarin works. Try to keep the amount of these foods in your diet about the same from week to week.
It is best to avoid alcohol while taking warfarin. Alcohol interferes with the effectiveness of warfarin.
Some herbal teas may cause the INR to become high or low.
Activities
Check with your doctor before starting any exercise or sports program. Your doctor may want you to avoid any activity or sport that may result in a serious fall or other injury.
Use a soft toothbrush. Brush and floss gently to prevent bleeding from the gums.
Be careful when using razors. We suggest using an electric razor or hair-removing cream to minimize the chance of cuts. If you do cut yourself, follow the guidelines below.
Illness and Emergencies
If you cut yourself and the cut is small, apply constant pressure over the cut until the bleeding stops (this may take up to 10 minutes). If the bleeding doesn't stop, continue to apply pressure and go to the nearest emergency room.
If the cut is large, apply constant pressure and get help immediately either by phone or by going to the nearest emergency room.
Call your doctor if you have any symptoms of illness such as vomiting, diarrhea, infection or fever. Illness can change the way warfarin works.
It is recommended that you wear or carry identification that states you are taking warfarin.
Avoid situations where you may get injured at home or at work.
Pregnancy
If you are a woman who is taking warfarin and is planning to become pregnant, talk with your doctor about the possible risks and ways to reduce those risks. Tell your doctor right away if you become pregnant.
Surgery and Dental Work
Before any treatment is provided, tell all your doctors and dentists that you are taking warfarin. Before having a surgical or dental procedure, you may need to have a blood test, and you may need to stop taking warfarin for a few days. Do not stop taking warfarin without first consulting with the doctor who monitors your warfarin/INR.
Travel
Check with your doctor before you travel. Before you go on vacation, you may need to have a blood test and your warfarin dose may need to be adjusted. While traveling, carry your medications with you at all times. Do not put medications in checked baggage, and do not leave your medications in the car.
When should I call my doctor?
Call your doctor if you notice any of the following signs of bleeding or illness that can affect the way your warfarin works:
Feeling more weak or tired than usual or looking pale (symptoms of anemia).
Bleeding from cuts that won't stop after applying pressure for 10 minutes.
Coughing or vomiting blood (which may look like coffee grounds).
Bleeding from the nose, gums or ears.
Unusual color of the urine or stool (including dark brown urine, or red or black, tarry stools).
Unusual bruising (black and blue marks on your skin) for unknown reasons.
Menstrual bleeding that is heavier or lasts longer than normal.
A fever or illness that gets worse.
A serious fall or a blow to the head.
Unusual pain or swelling.
Unusual headache.
Dizziness.
Difficulty breathing.
If you notice any of these symptoms, your doctor may want to do a blood test, stop the warfarin or prescribe medication to stop the bleeding. Also contact your doctor if you have any other symptoms that cause concern.
Blood clots can move to other parts of your body and cause serious medical problems, such as a heart attack. Warfarinwill not dissolve a blood clot; however, over time, the blood clot may dissolve on its own. Warfarin may also prevent other clots from forming or prevent clots from becoming larger. Warfarin will not dissolve a blood clot, but it may prevent other clots from forming and keep existing clots from getting larger. There are other blood thinners that you may be given in the hospital or even at home for a short amount of time: Heparin, Lovenox, or Fragmin. These drugs are administered either by vein (intravenous) or just under the skin into the subcutaneous fat.
Blood testing
In order for your health care provider to determine the correct dose of warfarin, it will be necessary for you to have blood tests. The tests are performed in a laboratory, usually once a week to once a month, as directed by your doctor. The prothrombin time (PT or protime) test is used to calculate your International Normalized Ration (INR). Your INR will help your health care provider determine how fast your blood is clotting and whether your medication dose needs to be changed. Illness, diet, medication changes and physical activities may affect your INR. Tell your health care provider about changes in your health, medications (prescription and over-the-counter) or lifestyle so appropriate dosage adjustments can be made in your warfarin therapy.
What does warfarin look like?
Coumadin brand tablets are round and scored, which means they can be broken in half. Each tablet color represents a different strength. The strength of the tablet is measured in milligrams (mg) as follows:
1 mg (pink)
2 mg (lavender)
2.5 mg (green)
3 mg (tan)
4 mg (blue)
5 mg (peach)
6 mg (teal or blue-green)
7.5 mg (yellow)
10 mg (white)
Other brands of warfarin should have the same colors and strengths as the Coumadin brand tablets. However, other brands of warfarin tablets may have a different shape or appearance. For example, they may be oval or square.
How should I take warfarin?
Take your warfarin dose as instructed once a day. Try to take it at the same time every day. A good time to take your warfarin is early in the evening (such as between 5 and 6 p.m.). Warfarin can be taken with or without food. Do not take a double dose to make up for a missed dose. Also, never change your dose without first discussing the change with your doctor.
How should I store warfarin?
As with any medication, store your warfarin at room temperature, away from extreme cold, heat, light or moisture. Bathroom cabinets are usually NOT suitable for storing medications because of the dampness. All medications, including warfarin, should always be kept out of the reach of children and pets.
What precautions should I take?
It is important that you follow these precautions when taking warfarin to reduce the risk of side effects and improve the effectiveness of your medication.
Medications and Dietary Supplements
Many medications and dietary supplements can affect the way warfarin works. These may include:
Prescription medications
Nonprescription medications such as aspirin, nonsteroidal anti-inflammatory drugs or NSAIDs (some examples are ibuprofen, naproxen or ketoprofen), cough or cold remedies and medications for pain or discomfort
Herbal products, natural remedies or nutritional supplements
Products containing vitamin K
Before taking any new medication, including over-the-counter medications, herbal products, vitamins, nutrition supplements, or medication prescribed by another doctor or dentist, check with the doctor who monitors your warfarin medication. Your warfarin doctor may need to adjust your warfarin dosage or may recommend another medication less likely to interfere with warfarin.
Diet
Eat a sensible, well-balanced diet.
Talk with your doctor if you are planning any major dietary changes such as following a weight-reducing diet or adding nutritional supplements.
Large amounts of food high in vitamin K (such as broccoli, spinach and turnip greens) may change the way warfarin works. Try to keep the amount of these foods in your diet about the same from week to week.
It is best to avoid alcohol while taking warfarin. Alcohol interferes with the effectiveness of warfarin.
Some herbal teas may cause the INR to become high or low.
Activities
Check with your doctor before starting any exercise or sports program. Your doctor may want you to avoid any activity or sport that may result in a serious fall or other injury.
Use a soft toothbrush. Brush and floss gently to prevent bleeding from the gums.
Be careful when using razors. We suggest using an electric razor or hair-removing cream to minimize the chance of cuts. If you do cut yourself, follow the guidelines below.
Illness and Emergencies
If you cut yourself and the cut is small, apply constant pressure over the cut until the bleeding stops (this may take up to 10 minutes). If the bleeding doesn't stop, continue to apply pressure and go to the nearest emergency room.
If the cut is large, apply constant pressure and get help immediately either by phone or by going to the nearest emergency room.
Call your doctor if you have any symptoms of illness such as vomiting, diarrhea, infection or fever. Illness can change the way warfarin works.
It is recommended that you wear or carry identification that states you are taking warfarin.
Avoid situations where you may get injured at home or at work.
Pregnancy
If you are a woman who is taking warfarin and is planning to become pregnant, talk with your doctor about the possible risks and ways to reduce those risks. Tell your doctor right away if you become pregnant.
Surgery and Dental Work
Before any treatment is provided, tell all your doctors and dentists that you are taking warfarin. Before having a surgical or dental procedure, you may need to have a blood test, and you may need to stop taking warfarin for a few days. Do not stop taking warfarin without first consulting with the doctor who monitors your warfarin/INR.
Travel
Check with your doctor before you travel. Before you go on vacation, you may need to have a blood test and your warfarin dose may need to be adjusted. While traveling, carry your medications with you at all times. Do not put medications in checked baggage, and do not leave your medications in the car.
When should I call my doctor?
Call your doctor if you notice any of the following signs of bleeding or illness that can affect the way your warfarin works:
Feeling more weak or tired than usual or looking pale (symptoms of anemia).
Bleeding from cuts that won't stop after applying pressure for 10 minutes.
Coughing or vomiting blood (which may look like coffee grounds).
Bleeding from the nose, gums or ears.
Unusual color of the urine or stool (including dark brown urine, or red or black, tarry stools).
Unusual bruising (black and blue marks on your skin) for unknown reasons.
Menstrual bleeding that is heavier or lasts longer than normal.
A fever or illness that gets worse.
A serious fall or a blow to the head.
Unusual pain or swelling.
Unusual headache.
Dizziness.
Difficulty breathing.
If you notice any of these symptoms, your doctor may want to do a blood test, stop the warfarin or prescribe medication to stop the bleeding. Also contact your doctor if you have any other symptoms that cause concern.
# posted by roodbont @ 1:57 PM 
