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What You Need to Know

The effects of anticoagulants must be monitored carefully with blood testing so that your warfarin doses can be adjusted accordingly. Our nurse specialists in the Anticoagulation Clinic work together with you, blood labs, and pharmacies to ensure that all blood tests and prescription doses are accurate and timely.

The success of anticoagulation therapy depends on your understanding and involvement. It's important that you attend all scheduled visits and take your medication as prescribed.

General information

  • Take your anticoagulant at the same time each day, preferably between 5:00 and 6:00 pm. If this is inconvenient, take it anytime in the evening. If you forget a dose, take it as soon as you realize you missed it, as long as it is the same day. Call the clinic for instructions if you realize you you missed a dose on the following day.
  • Report for your INR (International Normalised Ratio) / blood work appointment on the scheduled dates.
  • Avoid, if you can, over-the-counter aspirin products; Advil / ibuprofen / Motrin. If your doctor wants you to take aspirin, it is OK to continue to take it.
  • Keep your diet consistent with vitamin K foods. Do not avoid these foods, but eat them regularly. Consistency is key!
  • Avoid or limit your alcohol intake, no more than one drink per day, as a general rule. (One glass of wine, one beer or one ounce of hard liquor.)
  • Be careful! Avoid injuries. If you cut or bump yourself, you will bruise or bleed more than you did before taking the medication.

When to call us

  • It is very important to report any changes in your medications, including antibiotics, over-the-counter and herbal medications. Many medications can interact with your anticoagulants. You may be asked to have your INR checked to be sure it is at a safe level.
  • If you have an upcoming procedure, call us as soon as possible. You may need to put on hold your warfarin medication for the procedure or surgery.
  • Call to report any unusual signs of bleeding or increased bruising.
    • Unusual nose bleeds
    • Blood in urine or bowel movements
    • Abnormal vaginal bleeding
    • Cuts that will not stop bleeding with direct pressure for 10 minutes (report directly to Emergency Department for profuse bleeding)
  • Call to reschedule if you cannot make your appointment. If at any time you have your blood work drawn at a lab and do not hear from us within 24 hours, call us.
  • Report any major change in your diet, especially if you drink nutritional supplements like Boost, Ensure, etc.

Questions we may ask you

  • Have you had any recent changes in your medical condition?
  • Have you had any changes in the prescribed or over the counter medications/herbal remedies you take?
  • Have you missed any dose or taken more than the prescribed Coumadin since your last INR check?
  • Have you noted any signs and symptoms of increased bruising or bleeding, such as gums/teeth, stool/urine?
  • Has the amount of alcohol you used changed since your last INR check?
  • Has your diet changed, including nutritional supplements, since your last INR check?
  • Are you planning any travel in the near future?
  • Do you have any upcoming procedures or surgeries planned?
  • Do you need to renew your Coumadin prescription?

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