Anticoagulants and You

ANTICOAGULANTS AND YOU
A patient education guide
What are anticoagulants?
Anticoagulants are medicines that reduce/prevent blood clotting in an artery, a vein, or the heart.
Anticoagulants are called “blood thinners” even though they do not actually thin the blood.
Why would I need anticoagulants?
To reduce/prevent blood clots from forming. Blood clots can block the flow of blood and cause a stroke,
heart attack or other serious problems. An irregular heart rate (atrial fibrillation), or anticoagulation therapy can
decrease your risk for stroke by 60-80%. Anticoagulants are often used after certain surgical procedures where
activity is limited.
Could anticoagulants cause other problems?
Yes, they can, however if you follow your care instructions there probably won’t be any problems.
You must report the following problems right away:
 your urine turns red or dark brown
 your stools turn red, dark brown or black
 you bleed more than normal when you have your period
 your gums bleed
 you have a very bad headache or stomach pain that does not go away
 you get sick or feel weak, faint or dizzy
 you think you are pregnant
 you find more bruises or blood blisters on your body than usual
 you have an accident of any kind
What drugs are anticoagulants?
Coumadin (warfarin), Dicumarol (warfarin), Heparin, Lovenox
Are there reasons that I should not take one of these medications?
As with all drugs, the risks of taking any medication must be weighed against the good it will do.
You should discuss your other health issues, allergies or medications with your doctor before starting
anticoagulant therapy.
How do I take this medication?
Medications should be taken by mouth or injection, depending on the type. If it is an injection, your
nurse prior to discharge will teach you. Medications should be taken as directed by your doctor.
When do I take my medicine each day?
Generally, the medicine should be taken once a day, but must be taken at the
same time every day. The usual recommended time for Coumadin is 6:00 p.m. each day.
What if I miss a dose?
If you forget and more than 4 hours have gone by, miss that day’s dose.
DO NOT take a double dose to make up for a missed dose.Anticoagulants and You

How is anticoagulant therapy monitored?
A simple blood test called an INR (International Normalized
Ratio) is done. At the beginning of your treatment, it may be done
once or twice a week. Once your blood levels are stable the
frequency will reduce and is usually only done one time a month.
What about my other medications?
You can take your anticoagulant medication with most other medications. There are medications that
can affect your body’s response to the anticoagulant. Some of them are:
o Aspirin
o Ibuprofen (Advil, Motrin, Nuprin, Medipren, Excedrin IB, Haltran, Midol 200, Pamprin-IB, Trendar
and other products in this category)
o Naproxen (Aleve, Naprosyn, Anaprox)
o Ketoprofen (Ordis, Actron)
o Cimetidine (Tagament HB)
o Orfamotidine (Pepcid AC)
 Cold or sinus medications
o Alka-Seltzer
o Pepto-Bismol
o Vitamin E and Vitamin C
 Other over the counter meds
 Herbal medications
You should always discuss the medications you take with your doctor.
What does the doctor do with the test results?
Your medication dosage will be evaluated by your doctor and may be changed. We recommend that you
keep a calendar to help you keep track of the correct dosage.
Your other meds, illness, diet and general lifestyle can also affect your test results.
May I travel while taking anticoagulants?
Certainly. Just remember to keep you diet and alcohol intake consistent. Be sure that you have enough
medication. You may need to talk with your doctor if you are due for any blood testing while you are gone.
Do other care providers need to know about this medication?
Always tell other physicians or dentists that you are on anticoagulants.
Should I wear or carry information about my medication?
It is important to wear or carry identification that says you are on this type of medication.
Should I limit my daily activities?
Normal activities should not be affected by anticoagulant therapy. You must remember that you have an
increased risk for bleeding. Always check with your doctor before beginning any sport activity or situation that
could put you at greater risk for injury.Anticoagulants and You

Are there any concerns once I stop taking this medicine?
Yes, it will take a while for your body to recover and your blood clotting levels to return to normal. Your doctor
can tell you how long this may be. Use the same precautions used while on anticoagulant medications.
What if I get sick?
Many types of acute illness will change your body’s response to your medication. If you have a fever
(over 101ºF), flu, nausea and vomiting (more than 24 hours), congestive heart failure, or any type of viral or
bacterial infection; call your doctor. If you are prescribed an antibiotic, you will need to have your INR blood
level checked more often.
It is suggested that you have an INR test 7-10 days after having a flu shot, as it can also affect your
medication levels.
Does what I eat and drink matter?
The most important thing is to be a consistent eater. Some foods are high in
Vitamin K, which can affect the way the anticoagulant medication works. Common
foods that are high in Vitamin K are green leafy vegetables(broccoli, brussel sprouts,
cauliflower, spinach and other types of greens, chick peas, beef and pork liver. Just
keep your diet steady.
 Do not go on a weight reducing diet or take nutritional supplements while on
these medicines.
 Contact your doctor if you are unable to eat for several days, have stomach upset, diarrhea or fever.
 Be careful if the weather is very hot for several days. This could increase the effects of your medicine.
 Alcohol beverages, in small amounts are generally safe. This means a maximum of two drinks per day.
Alcohol can cause you to be at greater risk for injury.
What if I notice some unusual bleeding or other symptoms?
Notify your doctor if:
 your urine or stools turn red or dark brown
 your gums bleed
 you cough up blood
 continuing and severe headache
 chest pain
 dizziness, fainting, or sudden weakness
 numbness or tingling of your hands, feet or face
 paralysis
 joint pain, stiffness, or swelling
 unusual bruising or any other symptoms you have concerns about
 you bleed more than normal when you have your period or you have unexpected vaginal bleeding.
 NEVER HESITATE TO CONTACT YOUR DOCTOR IF YOU HAVE ANY CONCERNS
ABOUT ANTICOAGULANT MEDICATIONS.Anticoagulants and You

KEEP YOUR DIET STEADY
When you are on anticoagulants you must keep your diet steady when you eat certain foods.
Vitamin K is found in green leafy vegetables and it helps your blood clot. Your blood levels can
be affected by changes in the amount of these vegetables you eat. You don’t need to avoid
them, just keep the amount you eat the same from day to day.
The following foods are high in Vitamin K:
Asparagus ● Cauliflower ● Kale ● Sauerkraut
Avocado ● Coleslaw ● Lentils ● Soy Beans
Broccoli ● Collard Greens ● Lettuce ● Spinach
Brussel Sprouts ● Endive ● Liver ● Swiss Chard
Cabbage ● Garbanzo Beans ● Mustard/Turnip Greens ● Cranberry Juice
Oils, alcohol, and green and herbal teas can also affect you medicine.
Canola oil, soybean oil and mayonnaise are high in Vitamin K
Limit wine, beer, and hard liquor to no more than 1-2 drinks a day.
Green tea is high in Vitamin K. Teas with sweet clover, sweet woodruff or tonka beans are as
well.
Remember to keep your diet steady!