Heart failure medicine: Warfarin (Coumadin�)

Warfarin is a blood thinner (anticoagulant) that decreases the ability of your blood to form clots.

Helpful tip: It is a good idea to wear an identification bracelet that says you take warfarin.

Precautions

When you take this medicine, it is important to avoid activities in which you may be injured and bleed.

Use an electric shaver instead of a blade to avoid cutting yourself when you shave.
Use a soft-bristled toothbrush and floss gently to avoid bleeding gums.
Tell your health care provider if you have a dental or medical procedure planned. You may need to adjust your dosage for a short period of time.

Diet information

While taking warfarin, it is important to watch what you eat, drink and take.

Foods that are rich in vitamin K can affect the way warfarin works in your body. Vitamin K helps your blood make clots, while warfarin thins your blood. Green leafy vegetables (such as broccoli, cabbage, collard greens, spinach, kale and lettuce) and oils (canola, olive and soybean) have large amounts of vitamin K. The key is to keep your diet consistent with the amount of vitamin K you eat. This way your body will maintain a stable blood level of warfarin.
Drinking too much alcohol or green tea may change the way warfarin affects your blood clotting ability. Do not drink more than one alcoholic beverage each day. This does not mean you may skip one day and have two drinks the next day.
Some vitamins (vitamin E), herbs (St. John's wort) and supplements can change the effects of warfarin. It is important that you do not add or stop taking food supplements while you are taking warfarin, unless you have talked with your health care provider.

Helpful tip: If you take warfarin, the pain reliever of choice is acetaminophen (Tylenol).

Other medicines

Check with your health care provider before using any of the following medicines. They will increase your risk of bleeding.

alcohol
cimetidine (Tagamet�)
some antibiotics (erythromycin, Bactrim�)
aspirin
non-steroidal anti-inflammatories (Motrin�, Advil�, Nuprin�, Aleve� and Orudis KT�)

Side effects

Call your health care provider, if you have any unusual bleeding or bruising, abdominal pain that won't go away, or dark urine or dark stools.

Other side effects include:

headache
dizziness
weakness
unusual nosebleeds
throwing up blood

Blood test

The international normalized ratio (INR) blood test measures the time it takes your blood to clot. While you are on warfarin, you will take this test on a regular basis. The results of this test will tell your health team members if your warfarin dose needs to be adjusted.

Record your dose of warfarin and the results of your lab tests on your daily log or calendar. Record any missed doses as well.