Never skip a dose, and never take a double dose. A pillbox with a slot for each day may help you keep track of your medicines. Does the medicine seem different from what your doctor prescribed or look different from what you expected?
Does your pill look different from what you used before? Are the color, shape, and markings on the pill the same as what you were given before? Ginkgo biloba. Green tea. Return to Contents Talk to Your Other Doctors Because you take a blood thinner, you will be seen regularly by the doctor who prescribed the medicine.
If you use different pharmacies, make sure each pharmacist knows that you take a blood thinner. Tell your doctor about all your medicines.
Always tell your doctor about all the medicines you are taking. Tell your doctor when you start taking new medicine, when you stop taking a medicine, and if the amount of medicine you are taking changes.
When you visit your doctor, bring a list of current medicines, over-the-counter drugs—such as aspirin—and any vitamins and herbal products you take. A personal, medication wallet card can help you keep track of this list. Go to www. Return to Contents Possible Side Effects When taking a blood thinner it is important to be aware of its possible side effects. Call your doctor immediately if you have any of the following signs of serious bleeding: Menstrual bleeding that is much heavier than normal.
Red or brown urine. Bowel movements that are red or look like tar. Bleeding from the gums or nose that does not stop quickly.
Vomit that is brown or bright red. Anything red in color that you cough up. Severe pain, such as a headache or stomachache. Unusual bruising. A cut that does not stop bleeding. A serious fall or bump on the head. Dizziness or weakness. Return to Contents Stay Safe While Taking Your Blood Thinner Call your doctor and go to the hospital immediately if you have had a fall or hit your head, even if you are not bleeding. Tell others. Keep a current list of all the medicines you take.
Ask your doctor about whether you should wear a medical alert bracelet or necklace. If you are badly injured and unable to speak, the bracelet lets health care workers know that you are taking a blood thinner. To prevent injury indoors: Be very careful using knives and scissors. Use an electric razor. Use a soft toothbrush. Use waxed dental floss. An unusual headache or a headache that is more severe than usual may signal intracerebral bleeding.
If you experience the following signs of bleeding, you should call or your healthcare provider immediately:. Some simple changes to decrease the risk of bleeding while taking warfarin include the following:.
Changes in daily living can affect the INR. Warfarin is not recommended during pregnancy. A woman who becomes pregnant or plans to become pregnant while undergoing warfarin therapy should notify her healthcare provider immediately.
It is important to tell all your healthcare providers that you are taking warfarin. If you are having surgery, dental work, or other medical procedures, you may need to stop taking warfarin. Check with your healthcare provider if you expect to travel. While traveling, it is important to carry your medication with you at all times. Do not put medication into checked baggage.
Patients who take warfarin should consult with their healthcare provider before taking any new medication, including over-the-counter nonprescription drugs, herbal medicines, vitamins or any other products. Many medications can alter the effectiveness of warfarin, resulting in an INR that is either too high or too low. Some of the most common over-the-counter pain relievers, such as: ibuprofen brand name Advil and naproxen brand name Aleve , enhance the anticoagulant effects of warfarin and increase the likelihood of harmful bleeding.
Those who require long-term warfarin should wear a medical alert bracelet, necklace, or similar alert tag at all times. If an accident occurs and the person is too ill to communicate, a medical alert tag will help responders provide appropriate care. The alert should include a list of major medical conditions and the reason warfarin is needed, as well as the name and phone number of an emergency contact. Your healthcare provider is the best source of information for questions and concerns related to your medical problem.
Because no 2 patients are exactly alike, and recommendations can vary from 1 person to another, it is important to seek guidance from a provider who is familiar with your individual condition.
Written by American Heart Association editorial staff and reviewed by science and medicine advisers. See our editorial policies and staff. About Arrhythmia. Why Arrhythmia Matters. Revised April Medication Guides for prescription drug products. Poor compliance is a major factor in unstable outpatient control of anticoagulant therapy. Adverse drug reactions in a hospital general medical unit meriting notification to the Committee on Safety of Medicines.
Physician knowledge, attitudes, and behavior related to reporting adverse drug events. Schafer AI Warfarin for venous thromboembolism—walking the dosing tightrope. Landefeld CSGoldman L Major bleeding in outpatients treated with warfarin: incidence and prediction by factors known at the start of outpatient therapy. The outpatient bleeding risk index: validation of a tool for predicting bleeding rates in patients treated for deep venous thrombosis and pulmonary embolism.
Jaffer ABragg L Practical tips for warfarin dosing and monitoring. Save Preferences. Privacy Policy Terms of Use. This Issue. Citations View Metrics. Twitter Facebook More LinkedIn.
Original Investigation. July 9, Diane K. Use data. Aers data on bleeding with warfarin use. Anticoagulants attributed as causes of death on us death certificates. Nhamcs data on warfarin and bleeding. Access your subscriptions. Access through your institution. Add or change institution. Free access to newly published articles.
Purchase access. Rent article Rent this article from DeepDyve. Access to free article PDF downloads. Publications by Specialty. Diabetes Gastrointestinal disorders Infection and infectious diseases Mental health and illness Musculo-skeletal disorders Neurological disorders Public Health Radiology Reproductive health Sexual health Skin disorders. This page gives advice on management of patients taking warfarin in primary care during the Covid pandemic Advice on drug monitoring for other medicines during Covid is here Normal practice is to monitor INR up to a maximum of every 12 weeks During the Covid pandemic, recommendations to help minimise attendances include the following 1 For patients with prior DVT or PE and where risk of recurrence is now low, consider stopping warfarin 2 For other patients, consider switching to a DOAC; however, DO NOT switch if the patient: has prosthetic mechanical valve; consult cardiologist has moderate to severe mitral stenosis has antiphospholipid antibody syndrome APLS is pregnant, breastfeeding or planning pregnancy requires a higher INR than the standard INR range of 2.
Self-monitoring and community INR monitoring are options to reduce attendances; however: Where patients normally have their INR monitored more frequently than 12 weekly, consider moving to 12 weekly where safe to do so Patients should be reminded to contact their INR monitoring service via telephone if they experience COVID symptoms. Monitor patients INR within days, the exact timing of the INR should take into account relevant factors including: whether patient has symptoms of bleeding, is taking antibiotics or other new interacting medicine s , is feeling unwell, has reduced food intake, has recent alcohol consumption.
See options below Self monitoring Increasing self-monitoring may help reduce both attendances and INR monitoring workload across the system. Consider: Patients or family members need to be carefully selected for use of CoaguChek, taking into account their manual dexterity, cognitive function, vision and ability to use the technology. Patients or family members living with them will need to be taught to self-test their INR using a CoaguChek machine providing this can be obtained and to phone in the results.
There are challenges associated with implementation: e. Community monitoring via teams visiting patients Continuation of the safe monitoring of INR for patients in the community when isolated for long periods during COVID is essential.
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