What Is an Anticoagulant?

What Is An Normally, blood that is  for women; heavy or Anticoagulant? not anticoagulated has an increased bleeding An anticoagulant INR of approximately 1.0. during your period or prevents harmful clots The warfarin dose any other vaginal from forming in blood required to achieve target bleeding. vessels by making your INR varies for each If you cut yourself, apply blood take longer to clot. person. The frequency of firm pressure to the site Warfarin is the most blood tests depends on for at least 5 minutes commonly used oral how stable your previous using a clean, dry anticoagulant in this INR test results have dressing. country. been. If you cannot attend for a test, contact Seek immediate attention if you suffer major your anticoagulation How Do I Take trauma, or a blow to the clinic/doctor to make Warfarin? head, or are unable to another appointment, as Take your warfarin once stop bleeding. it is important that blood a day, at about the same Tell your doctor or dentist checks are performed time, between 6-8pm, that you are taking regularly. preferably on an empty warfarin if you require stomach with a full glass Changes in medication, surgery or dental of water. medical condition, diet, treatment. alcohol intake or not Consider using a soft taking your warfarin can What Do I Do if I Miss toothbrush to protect alter INR. It is important A Dose or I Take the gums and an electric or that you tell the Incorrect Dose? battery razor if shaving to anticoagulation If you remember the minimise risk of bleeding. clinic/doctor about any missed dose of warfarin changes. later the same day, take Side Effects Other Medications And it as soon as you The most serious side Herbal Products remember. If you don’t effect is bleeding. If you Many medicines may remember the missed experience any of the interfere with the action dose until the next day, following, seek immediate of warfarin. If you are leave it out completely. medical attention and starting or stopping If the dose you took in have an urgent INR test: another medication, error was much higher particularly some  prolonged nose bleeds than your normal dose, antibiotics, you may need (more than 10 please contact your more frequent blood minutes) anticoagulation tests. Contact your  prolonged bleeding clinic/doctor. anticoagulation clinic or from cuts your doctor/pharmacist  blood in sputum for further advice, as a  bleeding gums Monitoring Warfarin blood test may need to To monitor the effect of  blood in vomit be arranged within 4-7 warfarin you must have  passing blood (red or days of changing regular blood tests to dark brown) in urine medication. measure your  passing black or red International Normalised stools You should buy all your Ratio (INR). The INR is a  severe or spontaneous medicines and measure of how long bruising supplements from a your blood takes to clot.  unusual headaches pharmacy and tell the pharmacist you are taking cauliflower, avocado, tablets you need to warfarin. peas, asparagus, beans, take. lentils and liver. It is not Avoid aspirin and aspirin-  You may need a mixture necessary to avoid these containing medicines of tablet strengths to foods; eating moderate unless prescribed by your make your dose. quantities of these foods doctor who knows you  2 brands of warfarin are on a consistent basis will are taking warfarin. available in Ireland: not affect the action of Warfant® and Teva®. Avoid non-steroidal anti- your warfarin. Warfant® tablets Teva® tablets inflammatory drugs like ibuprofen (Nurofen®) Consistency in the intake which is available as an of certain other 1 mg (brown) 1 mg (brown) over-the-counter (OTC) foods/drinks is also medicine. Paracetamol important as sudden 3mg (blue) 3mg (blue) and codeine-based pain increases or decreases may modify the effect of killers are acceptable, 5 mg (pink) 5 mg (pink) although be aware that warfarin. These include fish oils, mango, soy milk some paracetamol  Always take the same and grapefruit juice. It is combination products brand of warfarin. recommended to avoid may contain aspirin.  If your warfarin brand is cranberry juice. Some alternative changed notify the It is important to keep anticoagulation clinic medicines and herbal your diet consistent. products may also affect promptly as it may the action of warfarin. affect your INR. Please check with your  An INR check should be anticoagulation clinic or done 5-7 days after a warfarin brand switch. your doctor/pharmacist Alcohol before use. It is recommended that you do not exceed the Travel Dietary Guidelines recommended upper limit If you plan to travel you It is important to eat a of 2 standard drinks per may need to make well-balanced diet and to day. arrangements to have keep your diet consistent your INR checked before 1 standard drink so the amount of Vitamin you go and whilst away. = 1 glass or half pint of K you eat is the same.  Contact the beer, lager or stout Foods rich in Vitamin K anticoagulation = 1 small glass of wine can cause warfarin to be clinic/doctor for advice = 1 single measure of less effective. Any major prior to travel. spirits, e.g. whiskey or changes in your diet may  Ensure you have vodka or gin. affect how your body enough warfarin to last responds to your warfarin It is dangerous to ‘binge through your trip. therapy. drink’ while taking  Do not put medications warfarin. in checked baggage. Foods rich in Vitamin K  Try to maintain your include green leafy usual diet. vegetables (e.g. brussel Tablet Brands and sprouts, kale, cabbage, Strengths spinach, lettuce),  Become familiar with Pregnancy and beetroot, broccoli, the different strengths Breastfeeding and colours of warfarin Warfarin can affect the If you have diarrhoea or 4284403 (Monday ─ development of a baby vomiting that lasts longer Friday, 08.00 ─ during the early weeks of than 24 hours contact 17.00 hours) pregnancy. Women who your doctor. If attending are taking warfarin the hospital Emergency should discuss plans for Department, tell staff you future pregnancy with are taking warfarin. their doctor before trying Warf to conceive. Contact Sports If your period is 1 week If you are involved in overdue and you think you contact sports, discuss might be pregnant, do a this with your doctor or pregnancy test. If the anticoagulation clinic. arin pregnancy test is positive, you should contact your Patient doctor and the Contacting the anticoagulation clinic Anticoagulation Clinic Information urgently. If the test is at negative, re-test every 3 Leaflet St. James’s Hospital days until either the period arrives or the test is  Appointments: positive. Telephone: 01 4162637 (Monday ─ You may breastfeed while Thursday, 14.30 ─ taking warfarin. 15.30 hours) St. James’s Hospital,  Nurse Helpline: James’s St., Dublin 8 Illness Telephone: 01