Has your doctor prescribed you to use the medicine Warfarin? Or is a family member or friend using this medicine? This is actually a very important medicine that prevents blood clots. But there are some things we need to be very careful about when using this. Don't worry, we will talk about all of it simply and clearly today.
What exactly is Warfarin?
Simply put, Warfarin is a medication that prevents blood from clotting, or slows it down. In medicine, we call this an anticoagulant . You may be familiar with this medication by the brand names Coumadin® or Jantoven®.
This medicine works by preventing unwanted blood clots from forming inside your body, in your blood vessels or in your heart. These unwanted blood clots can form in certain medical conditions, or when you are unable to walk or move around for a long time.
The important thing is that Warfarin prevents new blood clots from forming, but it does not dissolve existing blood clots . However, it does stop the clot from getting bigger. Over time, the clot may dissolve on its own.
What are the uses of Warfarin?
Your doctor may have prescribed this medicine to prevent or treat the following conditions:
| Medical condition | A simple explanation |
|---|---|
| Blood clot in the veins (Venous thromboembolism - VTE) | A blood clot that forms in a vein breaks loose and gets stuck somewhere else. |
| Deep vein thrombosis (DVT) | A blood clot, often in a deep vein in the leg. |
| Pulmonary embolism (PE) | A blood clot that has formed in a vein breaks loose and becomes lodged in the lungs. |
| Blood clot in the artery (Arterial thromboembolism - ATE) | Formation of a blood clot in an artery. |
| Stroke | A blood clot blocks a blood vessel that carries blood to the brain. |
| Heart attack | Blockage of an artery supplying blood to the heart by a blood clot. |
Additionally, this medication is also prescribed to prevent the risk of blood clots if you have an irregular heartbeat (Atrial fibrillation - Afib) or have undergone heart valve replacement surgery .
How does this medicine work?
Very simple. Vitamin K is essential for our blood to clot. Warfarin works by blocking the action of vitamin K, which is needed for some of the factors that help in the blood clotting process. This slows down the rate at which blood clots and prevents the formation of unwanted blood clots.
Medication dosage and mandatory blood tests
The dose of warfarin usually varies from 1 mg (milligrams) to about 10 mg. Your doctor will give you a specific dose. However, that dose may need to be adjusted based on the results of regular blood tests.
These pills come in different colors. Each color represents the number of milligrams in the pill. For example, if you are given a 5mg pill and then told to reduce the dose to 2.5mg, you should break the 5mg pill in half and take that half. Never change the dose without consulting your doctor.
What are these blood tests that need to be done?
When taking warfarin, you will need to have a blood test called PT/INR (Prothrombin Time / International Normalized Ratio) regularly.
This test measures how quickly your blood clots. The results can help your doctor determine if Warfarin is working properly for you and if your dosage needs to be adjusted.
This test may be done once a week or once a month. Your doctor will decide.
- Other medications you take (even vitamins and painkillers), changes in your health (such as fever or diarrhea), and changes in your diet can affect your PT/INR. Therefore , it is important to inform your Warfarin doctor about any changes in your life.
Do these things exactly when taking Warfarin
- Take the medicine at the same time every day . You only have to take it once a day.
- Can be taken before or after meals.
- If you forget to take your medicine and remember within 8 hours, take the dose right away.
- However, if it has been more than 8 hours, skip that day's dose and take only the next day's dose. Never take two doses at once.
- If you forget to take your medicine for two days or more, be sure to call your doctor.
The main side effect: Be careful of bleeding!
The main and most common side effect of warfarin is excessive bleeding . This is because this medication works by preventing blood clotting. If you experience any of the following symptoms, call your doctor right away.
| Sign to pay attention to | Description |
|---|---|
| Notify the doctor immediately. | |
| Bleeding from a minor injury | Bleeding that does not stop even after applying pressure for 10 minutes. |
| Bleeding from the nose and gums | Bleeding that doesn't stop for more than 10 minutes. |
| Change in urine color | Urine turning red or dark brown (rusty). |
| Change in stool color | Bright red or tarry black stools. |
| Coughing up blood or vomiting | Coughing up blood or vomit that looks like coffee grounds. |
| Bruises without a cause | Bruises, purple spots, or swelling and pain anywhere on the body for no reason. |
| Women's menstruation | Menstrual bleeding that is heavier than normal or lasts longer than usual. |
| Unusual headaches or dizziness | Severe headache, dizziness, sudden change in speech or vision, numbness of the face or arm. |
When is emergency treatment needed?
- If the bleeding does not stop after 10 minutes of pressure on a minor wound, continue to apply pressure and go to the nearest Emergency Department (ETU) .
- If you have a serious injury and are bleeding heavily, call 1990 immediately or go to the ETU with someone's help as soon as possible.
Learn more about food and vitamin K
This is where many people make a mistake. Some people think that they should completely stop eating foods containing vitamin K when taking warfarin. This is wrong.
The most important thing is to maintain the same amount of vitamin K-rich foods you eat from week to week . Eating a lot one week and not eating at all the next week can cause a big difference in your INR.
Foods rich in vitamin K (keep the amount you eat per week consistent):
- Dark green vegetables like kale, broccoli, spinach, and collard greens
- Types of lettuce
- Asparagus
If you're looking to increase your vegetable intake, you can choose vegetables that are low in vitamin K, such as:
- Corn, pumpkin, potatoes, carrots, cucumbers, tomatoes.
Important: Before making any major changes to your diet (e.g. starting a weight loss diet), be sure to talk to your doctor.
Things to avoid when taking Warfarin
- Other medications: Do not take any medication (even painkillers, vitamins, or Ayurvedic medicines) without consulting your doctor.
- Surgery: Before having even something as minor as a tooth extraction, you should tell your dentist or surgeon that you are taking Warfarin.
- Food and Drink: Avoid drinking grapefruit, pomegranate, and cranberry juice.
- Alcohol: Avoid drinking alcohol. It can increase the risk of bleeding.
- Pregnancy: Avoid becoming pregnant while taking warfarin. If you are planning to become pregnant, talk to your doctor about it.
- Accidents: Protect yourself as much as possible from accidents such as falls and hard impacts. If you play sports, consult your doctor about that as well.
Take-Home Message
- Warfarin is a very important medicine that prevents blood clotting. Take it exactly as your doctor tells you, at the right time, in the right dose.
- Do not stop taking the medication or change the dosage for any reason without consulting your doctor.
- Never skip a PT/INR blood test. It is essential for your safety.
- If you notice any signs of unusual bleeding (hard bruising, black stools, red urine), seek medical advice immediately.
- Always inform your doctor about any changes in your diet, other medications you are taking, or health conditions.
- Before having a tooth extraction or surgery, you must tell the doctor in question that you are taking Warfarin.
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