SAMMC Departments: Coumadin - Precautions & Advice

Patient Information

Coumadin

Don't Mix Other Medications with Coumadin®

The chief precaution with this drug revolves around interactions with other drugs. Some medications magnify the Coumadin® effect, and some act as a relative antidote. Many common over-the-counter medications or remedies interfere with Coumadin® regulation. Be advised that starting or stopping any medication could potentially affect your Coumadin® control. It is important to recheck your I.N.R. whenever starting or stopping any other medication. Aspirin is the most common drug which affects Coumadin® regulation. Alcohol, antacids, antihistamines, antibiotics, and many other common medications also affect Coumadin®. A list of medications which are known to interfere with Coumadin® is included in this web site.

Follow a Schedule

Take your fill at the same time every day. It is easier to adjust your dose if you take your medicine in the evening. Although Coumadin® can be taken any time in the day, it is prudent to take your dose at the same time each evening. If the doctor calls to adjust your dose, it is not much help if you have already taken your pills for the day. Thus the evening dosage schedule allows for easier adjustment. Many patients use a metered pillbox (one slot for each day of the week) and place it next to their toothbrush, for a convenient reminder.

Check Your Pills

It is possible for Coumadin® pills to become mixed up. Even pharmacists have occasionally made errors, giving out the wrong tablet strength. Some patients who have had more than one strength of tablet in the household have mixed them up, with a resulting change in therapeutic dose. Keep close track of the color and insignia (indicating milligram strength) on each tablet, and at the time each prescription is filled.

Plan Ahead

If you are planning to travel outside of the country, refill your prescription. Make sure you have enough tablets for the entire trip, plus extras. Obtain your Pro-Time / I.N.R. before leaving to make sure that your dosage is proper.

Inform Others

Let your family know you are taking anticoagulants. Make sure all your treating physicians know, especially new consultants who you have never seen before. Wear a Medic-Alert band or I.D. bracelet which informs others that you are taking Coumadin®. Make sure your dentist is aware as well.

Dental Check-Ups

First, let your dentist know that you are taking Coumadin®. Have regular check-ups to prevent and treat gum disease that might predispose you to bleeding during brushing or flossing.

Special Precautions

Avoid traumatic sports, if possible. Wear protective gear for activities like bicycle or horseback riding. Use a soft toothbrush to prevent gum injury. Use an electric razor rather than a straight or blade razor. Wear gloves while gardening.

Blood Testing

Dosing of Coumadin® is individualized to each patient. There are different ranges of target values in different situations. It is important to know what target range your physician is using to treat your condition. Continue to have your blood draws as directed by your physician and / or nurse. After each blood draw, keep in touch with your physician's clinic to find out the results and what new dosage may be needed.

Pregnancy

Coumadin® is contraindicated in pregnancy. If pregnancy is a consideration, please consult your physician as soon as possible, preferably before conception.

What To Look For

The following symptoms could be a sign of excessive Coumadin® dosage. If any of these symptoms occur, consult your clinic or physician.

Nose bleeds
Bleeding gums
Red or brown urine
Red or black stools
Cuts that do not stop bleeding
Bruises that enlarge
Excessive menstrual flow
Headaches
Abdominal pain
Faintness, dizziness, or unusual weakness
Additional information about Coumadin® can be obtained through our web site.

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Coumadin Information

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