The Derby Medical Centre, 8 The Derby Square, Epsom, Surrey, KT19 8AG

Telephone: 01372 726361

Anticoagulation/Warfarin

Anticoagulation

The Derby medical Centre run a clinic for monitoring anticoagulation medication. Anticoagulation is a medicine which is used to stop the blood clotting in blood vessels and is used in a variety of illnesses to prevent stroke and heart attacks.

The dose of your anticoagulation is calculated after testing the blood to see how easily it clots. It is important to have this monitored regularly. The anticoagulation is affected by many things such as other drugs, food and alcohol. When you are first advised to take these medicines our trained nurse provide education and on going support regarding your medicine.

Side Effects

The most important side effect is signs of bruising and bleeding and report these to the clinic nurse. Signs to look for are listed below:-

Nose Bleeds Bleeding from gums Red/Pink colour in urine Blood in stools or black stools Persistent headache Excessive bruising

Monitoring of Warfarin

The practice runs a warfarin clinic for the monitoring of the drug and review of its dosage.

Warfarin stops the blood from clotting within your blood vessels. It is also used to stop existing clots getting bigger and stops parts of clots breaking off and forming emboli. Clotting is delayed because the warfarin inhibits the production of Vitamin k in the liver thus making it longer for the blood to clot.

Treatment is safe so long as you follow the advice from your doctor or nurse and in your Anticoagulant therapy Record

You will need to have a blood test at regular intervals.The reading obtained by testing your blood is called your INR. This may vary but will need to be kept within a certain range depending on the reason why you are taking warfarin. This is called the therapeutic range and will be decided by your doctor.

Why is Warfarin Prescribed?

  • Atrial Fibrillation
  • Artificial heart valves (AVR or MVR)]
  • Deep Vein Thrombosis (DVT)
  • Pulmonary Embolism (PE)
  • Heart Attack or Ischaemic heart Disease
  • Prevention of Blood Clots

Important Information

You should

    1. Have regular blood tests
    2. Report any bleeding or bruising
    3. Take your anticoagulation medicine at the same time each day
    4. Take the dose of anticoagulant as prescribed
    5. Inform your clinic or doctor of ant new drugs you are taking
    6. Eat a balanced diet
    7. Carry your anticoagulation record book (yellow book) with you
    8. Inform your doctor/dentist /pharmacist you are taking warfarin

You should not

      1. Take aspirin or medicines containing aspirin unless advised by your doctor
      2. Take more than moderate amounts of alcohol
      3. Miss a dose of your medicine unless advised to do so
      4. Take extra doses or change your dose of anticoagulant
      5. Run out of anticoagulant tablets

Warfarin tablets
Pink /5mg Blue/3mg Light brown/1mg White/0.5 mg

Side Effects

The most common side effects are bleeding and bruising. All side effects and especially bruising and bleeding should be reported to your doctor

IN THE EVENT OF PROLONGED BLEEDING INFORM YOUR GP OR HAEMATOLOGIST OR GO TO THE NEAREST CASUALTY DEPARTMENT FOR URGENT TREATMENT.

Other problems

Other medications

It is important to take all medications that have been prescribed for you. Some drugs affect how warfarin works. Always ensure the doctor knows you are on warfarin if a new drug is prescribed. You may need to have additional blood tests when you start a new drug or stop a drug. Many antibiotics cause problems with INR readings and may require additional tests.

Vitamins and Herbal Supplements

Most vitamins and herbal supplements have the potential to interact with warfarin. Always tell the clinic if you are starting them or stopping them as you may require further monitoring.

Effects on Lifestyle

Diet

There are no dietary restrictions while you are on warfarin as long as you eat a healthy well balanced diet and avoid strict diets or crash diets. It is important that your diet contains moderate amounts of foods containing Vitamin K (listed below), taking them in excess may lower your INR blood test.

Vitamin K rich foods

        • Cabbage
        • Chives
        • Brussel sprouts
        • Spinach
        • Cauliflower
        • Turnip greens
        • Watercress
        • Lettuce
        • Spring onions
        • Green beans
        • Asparagus
        • Broccoli
        • Avocado
        • Chickpeas
        • Rape seed oil
        • Soya bean oil
        • Liver
        • Egg (yolks)
        • Mature cheese
        • Cereals(wheat bran & oats)

Alcohol

Alcohol may affect your INR reading. Drinking in moderation is allowed. Moderation is defined as 2 units per day for 7 days a week. Binge drinking or sudden increases or decreases in the amount of alcohol you drink may alter your INR levels.

Travel

It is advisable to have your INR checked before any overseas travel to ensure the correct dose while you are away from home.

Dentist

You should tell your dentist that you are taking warfarin and also any other medication.

Pregnancy

Oral anticoagulation medicine taken in early pregnancy can damage the unborn baby. You should not become pregnant while taking anticoagulation medicine without consulting your doctor.

Useful contacts

AntiCoagulation Europe and advise you about getting a MediPAL medical alert card.

Living with WARFARIN booklet is available from your GP or anticoagulation clinic.

www.anticoagulationeurope.org