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Anticoagulation Services

Anticoagulation Services at the Heart and Vascular Center assist you with ongoing monitoring, blood testing, and dosing instructions when taking warfarin, a blood thinner (also known by the brand names Coumadin® and Jantoven®).

Our specialty nursing teams work with your cardiologist to manage your anticoagulation therapy. The effects of warfarin must be monitored carefully with blood testing so that your doses can be adjusted if necessary. Our nurse specialists in our anticoagulation service 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.

You may be prescribed an anticoagulant by your physician, or upon discharge from the hospital, for the following conditions:

General information about taking warfarin

  • 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 on the following day that you missed a dose.
  • Report for your INR (international normalized ratio)/blood work appointment on the scheduled dates.
  • Avoid, if you can, over-the-counter pain-relieving products such as Advil, ibuprofen, and Motrin. Only take aspirin if approved by your cardiologist.
  • Foods with vitamin K, such as leafy vegetables, can affect warfarin. You do not need to avoid these foods, but eat approximately the same amount on a daily basis. Consistency is the key.
  • Avoid or limit your alcohol intake to no more than one drink per day, as a general rule.
  • Be careful! Avoid injuries. If you cut or bump yourself, you will bruise or bleed more than you did before taking the medication.

Refer to the following health information related to anticoagulation:

When to call us at (603) 650-5866

  • 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 temporarily stop  your anticoagulant medication for the procedure or surgery.
  • Call to report any unusual signs of bleeding or increased bruising, including:
    • 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 the closest 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 or Ensure.

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 or herbal remedies you take?
  • Have you missed any dose or taken more than the prescribed dose since your last INR check?
  • Have you noted any signs and symptoms of increased bruising or bleeding, such as from your gums or teeth, or in your stool or 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 anticoagulant prescription?
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