Phone number Appointment date I willfollowupwith Notes Date: Warfarin (Coumadin) mg tablets INR: Sun Mon Tues Wed Thurs Fri Sat REV 7/12J14849DC14120 Tab(s) Tab(s) Tab(s) Tab(s) Tab(s) Tab(s) Tab(s) (Coumadin®) Warfarin Understanding Key Questions What is Warfarin? 1. Why am I taking warfarin (Coumadin®, Your doctor wants you to take the drug Jantoven®)? warfarin. Warfarin is the generic name – To keep from getting a blood clot for this drug. You may have also heard it called Coumadin® or Jantoven®. 2. What do I need to do to take this medication safely? Warfarin can help stop blood clots. – Take my medicine at the same time It can also keep clots from getting each day larger. Sometimes blood clots form – Watch for signs of bleeding on surfaces of blood vessels due to – Make sure everyone knows I am taking the drug warfarin damage to that blood vessel. Others form in the heart due to damage in – Keep an up-to-date medication list the heart. When blood clots form, they – Keep my diet steady can break off and move to other parts – Have my blood tested regularly of your body such as your arms, legs, 3. Why is it important to take warfarin lungs and even your brain. If a blood safely? clot blocks a blood vessel, it can stop – To keep from getting a blood clot the flow of blood, damage tissue, and and reduce side effects can even cause death. This brochure will tell you what to expect when you take the drug warfarin. If you have questions, ask your doctor, nurse or pharmacist. Watch the video “Warfarin and You” online at bronsonhealth.com/warfarin Side Effects Warfarin has been used for more than 50 years. It is a safe drug and is well tolerated by most people. However, some patients do have side effects. Common Side Effects These are side effects that you may experience. It is probably OK to keep taking your medicine. If you are not sure and something does not seem right, call your doctor or pharmacist. • Gum bleeding while brushing teeth • More nosebleeds than usual • Easy bruising Taking Warfarin • Bleeding after a minor cut that stops within a few minutes Warfarin is a safe, yet powerful, drug. • Menstrual bleeding that is a little heavier Please be careful how you take it. • Do not take more than the dose Serious Side Effects prescribed by your doctor. These side effects are very serious. If any of • Keep your pills at room temperature these happen, call your doctor or pharmacist and away from heat, moisture and right away. direct light. • Take your dose at the same time each • Red, dark, coffee or cola colored urine day. It is helpful to make this part of • Bowel movements that are red or your daily routine. look like tar • If you forget to take a dose, take it as • Bleeding from the gums or nose that soon as you remember, unless it has does not stop quickly been more than 12 hours since your • Vomit that is coffee-colored or bright red usual dose time. • Anything red in color that you cough up • Do not take a double dose of warfarin • Severe pain, such as a headache the next day to make up for the • Sudden appearance of bruises for missed dose. no reason • If you forget a dose, write it down. • Menstrual bleeding that is much heavier At your next visit, tell your doctor or than normal pharmacist about the missed dose. • A cut that will not stop bleeding within • If you are not sure whether you 10 minutes should take a dose, call your doctor or • A serious fall or hit on the head pharmacist. • Dizziness or weakness Drug Interactions Other drugs affect how warfarin works. This means you may be at increased risk for a blood clot or too much bleeding. That is why it is so important to tell your doctor and pharmacist about all of your medications, vitamins, herbal and dietary supplements, and anything else you are taking. They will help you decide what is best for you. Common drugs that interact with warfarin include many over-the-counter pain relievers, such as: Your Diet • acetaminophen (Tylenol®) Your doctor and pharmacist want you • aspirin and products that contain aspirin to be healthy while taking warfarin. A (including ointments and Pepto-Bismol®) healthy diet rich in vitamins can help you • ibuprofen (Motrin®, Advil® and Nuprin® heal faster. • naproxen (Aleve® and Orudis KT®) Be aware that foods that have a lot of vitamin K can affect the way that warfarin works. These include dark, leafy green vegetables such as collard greens and spinach. You do not have to avoid these foods. Just make sure you are eating the same amount of foods with vitamin K from week to week. For more information about the vitamin K content of foods, ask your doctor or pharmacist. You may also call Bronson HealthAnswers at (269) 341-7723 or toll-free (800) 451-6310 (online at bronsonhealth.com). Changes in your diet, health or lifestyle can affect the way your body reacts to warfarin. Let your doctor or pharmacist know: • if you have been sick • if you have started or stopped any medicines, including prescription and non-prescription (over-the-counter) medicines, herbal or dietary supplements, or vitamins • if you have had a change in your diet or activity level Follow Up Care Make sure all of your Your doctor has prescribed a dose of doctors, including your warfarin that is right for you. This amount may change over time. dentists, know that you To make sure you are getting the right are taking warfarin. dose, you will need to have blood tests on a regular basis. The test is called an international normalized ratio (INR). The You may need to stop INR shows how fast your blood clots. using the medicine It is very important that you keep all your appointments and follow the schedule before having surgery your doctor or pharmacist recommends. At first, you will need to have your blood or some medical tests. tested often. INR tests may be done at your doctor’s office, lab or at an anticoagulation clinic. Your dosing will be managed by your doctor or pharmacist. Things to Remember Resources: Bronson Anticoagulation Clinic • Take your dose at the same time 601 John Street each day. If you miss a dose, take it Medical Office Pavilion, M– 425 as soon as you remember, unless it Kalamazoo, MI 49007 has been more than 12 hours since (269) 341-7909 your usual dose time. Bronson Battle Creek Outpatient Pharmacy • Never double up doses if you Medical Office Building 363 Fremont Street miss a dose. Battle Creek, MI 49017 (269) 245-8646 • Call your doctor or pharmacist if you notice any signs of bleeding Bronson Outpatient Pharmacy or illness. 601 John Street Medical Office Pavilion, 1st Floor • Remember to tell all your doctors, Kalamazoo, MI 49007 including your dentists, that you (269) 341-6990 are taking warfarin. Bronson Pharmacy Mattawan 52375 N. Main Street • Tell your doctor and pharmacist Mattawan, MI 49071 about all of your medicines, (269) 668-6205 vitamins, herbal and dietary Agency for Healthcare Research supplements. and Quality (AHRQ) “Your Guide to Coumadin®, Warfarin, • Try to keep your diet moderate Therapy” www.ahrq.gov and consistent. Eat the same Watch the video “Warfarin and You” amount of vitamin K each week. online at bronsonhealth.com/warfarin • Go to your blood test appointments. .