Coumadin Drug Information

Coumadin is an anticoagulant (blood thinner). Coumadin reduces the formation of blood clots. Coumadin is used to prevent heart attacks, strokes, and blood clots in veins and arteries.
What is the most important information I should know about Coumadin ?
• Never take a double dose of this medication.
• Do not take aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Motrin, Advil, Nuprin, others), ketoprofen (Orudis, Orudis KT, Oruvail), naproxen (Naprosyn, Aleve, Anaprox), and others while taking Coumadin, except under the direction of your doctor. These medicines increase the risk of bleeding.
• Avoid sudden changes in your diet. Vitamin K decreases the effects of Coumadin. Large amounts of vitamin K are found in foods such as liver, broccoli, brussels sprouts, and green leafy vegetables (e.g., spinach, Swiss chard, coriander, collards, cabbage). Do not change the amount of these foods in your diet without first talking to your doctor.
• It will be necessary to regularly monitor your therapy with a blood test called a "PT" or an "INR." These tests help to determine the amount of Coumadin that you need to take.
• Contact your doctor if you experience any unusual bruises or heavily bleeding wounds, diarrhea, infection, or fever during treatment with Coumadin. What is Coumadin?
• Coumadin is an anticoagulant (blood thinner).
• Coumadin reduces the formation of blood clots, which is important in the prevention of heart attacks, strokes, and blockage of major veins and arteries.
• Coumadin may also be used for purposes other than those listed in this medication guide.
What should I discuss with my healthcare provider before taking Coumadin?
• Do not take Coumadin if you:
· recently had surgery;
· have a stomach ulcer or bleeding in the stomach;
· have had a certain type of stroke caused by bleeding in the brain;
· have had an aneurysm;
· recently had a spinal puncture or lumbar block anesthesia; or
· have bacterial endocarditis (infection of the heart), pericarditis (swelling of tissue around the heart), or pericardial effusion (build-up of fluid around the heart).
• Before taking Coumadin, tell your doctor if you :
· have kidney disease;
· have liver disease;
· have high blood pressure;
· have a hereditary protein C or protein S deficiency;
· are diabetic;
· have polycythemia vera;
· have vasculitis;
· have congestive heart failure;
· have a collagen vascular disorder such as systemic lupus erythematosus;
· have thyroid disease;
· have high cholesterol;
· have cancer;
· have a vitamin K deficiency;
· are considering having surgery; or
· are taking antibiotics to treat an infection.
• You may not be able to take Coumadin, or you may need a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.
• Coumadin is in the FDA pregnancy category X. This means that Coumadin is known to cause birth defects in an unborn baby and must not be taken during pregnancy. Do not take Coumadin if you are pregnant or could become pregnant during treatment. Consult your doctor immediately if you become pregnant while taking Coumadin.
• Coumadin has not been detected in human breast milk. Talk to your doctor before taking Coumadin if you are breast-feeding a baby.
How should I take Coumadin?
• Take Coumadin exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.
• Take each dose with a full glass of water.
• It is important to take Coumadin at the same time every day. Coumadin can be taken with or without food.
• It is important to take Coumadin regularly to get the most benefit.
• Never take a double dose of this medication.
• Do not stop taking Coumadin without first talking to your doctor.
• It will be necessary to regularly monitor your therapy with a blood test called a "PT" or an "INR." These tests help to determine the amount of Coumadin that you need to take. Your doctor may also want you to have other blood tests or medical evaluations during treatment with Coumadin to monitor progress and side effects.
• Do not take any more or less of this drug than is prescribed for you.
• Avoid sudden changes in your diet. Vitamin K decreases the effects of Coumadin. Large amounts of vitamin K are found in foods such as liver, broccoli, brussels sprouts, and green leafy vegetables (e.g., spinach, Swiss chard, coriander, collards, cabbage). Do not change the amount of these foods in your diet without first talking to your doctor.
• Contact your doctor if you experience any unusual bruises or heavily bleeding wounds, diarrhea, infection, or fever during treatment with Coumadin.
• Store this medication at room temperature away from moisture and heat.
What happens if I miss a dose?
• Take the missed dose as soon as you remember, on the same day. If the missed dose is not remembered until the next day, skip that dose and take only the next regularly scheduled dose. Never take a double dose of this medication.
What happens if I overdose?
• Seek emergency medical treatment.
• Symptoms of a Coumadin overdose include bruising; small, broken blood vessels under the skin; excessive bleeding from cuts or wounds; bleeding from the gums; blood in the stools, urine, or vomit; and excessive menstrual bleeding in women.
What should I avoid while taking Coumadin?
• Avoid sudden changes in your diet. Vitamin K decreases the effects of Coumadin. Large amounts of vitamin K are found in foods such as liver, broccoli, brussels sprouts, and green leafy vegetables (e.g., spinach, Swiss chard, coriander, collards, cabbage). Do not change the amount of these foods in your diet without first talking to your doctor.
• Do not take aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Motrin, Advil, Nuprin, others), ketoprofen (Orudis, Orudis KT, Oruvail), naproxen (Naprosyn, Aleve, Anaprox) and others while taking Coumadin, except under the direction of your doctor. These medicines increase the risk of bleeding.
• Tell your doctor (or dentist) that you are taking Coumadin before taking an antibiotic or before having surgery.
• Do not start or stop taking any other medications during treatment with Coumadin without first talking to your doctor.
• Avoid hazardous activities and sports that may cause injuries. Bleeding and bruising may be a problem, especially at the start of therapy. Watch for excessive bleeding and bruising and report any unusual bruises or heavily bleeding wounds to your doctor.
• Avoid the use of alcohol and tobacco products. These products can alter the effects of Coumadin and cause problems with your therapy. Discuss the use of alcohol and tobacco with your doctor.
What are the possible side effects of Coumadin?
• If you experience any of the following serious side effects from Coumadin, stop taking the medication and seek emergency medical attention or contact your doctor immediately:
· an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives);
· black, bloody, or tarry stools;
· blood in urine or vomit;
· coughing up blood;
· bleeding gums or sores in the mouth;
· decreased urine production;
· yellowing of the skin or eyes;
· severe dizziness or headache;
· easy bleeding or bruising under the skin;
· purple discoloration of the toes or fingers;
· sudden leg or foot pain; or
· unusually heavy menstrual periods.
• Other, less serious side effects may be more likely to occur. Talk to your doctor if you experience
· excessive gas or bloating;
· diarrhea, nausea, or vomiting;
· hair loss; or
· decreased appetite or weight.
• Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.
What other drugs will affect Coumadin?
• Coumadin interacts with many other drugs, and these interactions can be dangerous, even fatal. Before starting treatment with Coumadin, tell your doctor and pharmacist about all medicines you take including prescription medicines, over-the-counter products, vitamins, minerals, and herbal products. Talk to your doctor and pharmacist before taking any other medication during treatment with Coumadin.