Anticoagulation Management

 

Why is anticoagulation checked?

In certain medical conditions the blood requires a longer time to clot. Warfarin does not thin the blood, but delays the clotting time. Warfarin is taken once a day and in the evening. To determine the correct dosage, we do a blood test called (INR) International Normalised Ratio.

 

How is it done?

The nurse will see you by appointment. You will be asked to wash your hands. A device called a lancet will be used to prick the tip of the finger. This is a painless procedure. A drop of blood is then placed onto a test strip. This procedure provides us with the result which we then enter into a web based software which provides your next dosing schedule and your next visit all in one step. We will provide you with a printout.  The whole appointment will be no longer than 10 minutes.

 

What medical conditions require anticoagulation?

• Certain heart conditions.
• To prevent strokes.
• For irregular heart rates called arrhythmia.
• Thrombosis of veins in the legs (Deep Vein Thrombosis).
• Heart valve replacement.

 

What medicines and food items are to be avoided?

 

Medicines: Aspirin, nonsteroidal anti-inflammatory drugs such as all Voltarol (Diclofenac), Ibuprofen (Nurofen), Cimetidine (Zantac). You should avoid medication containing Vitamin K and Vitamin E in a strength greater than 400I/U.

 

Food

Conventional Medicine	Potential Interaction	Comments
Angelica	May increase the effects of warfarin
Arnica	May increase the effects of warfarin
Boldo	May reduce anticoagulant effect of warfarin
Coenzyme Q10	Reduces anticoagulant effect	Avoid use of products containing Co Enzyme Q10
Dansheen	Increased bleeding time	Advise patients not to use whilst taking warfarin
Devils Claw	Increases anticoagulant effect	Bleeding disorders visible on the skin (purpura) have been reported
Dong Quai	Increased bleeding time and widespread bruising	Advise patients not to use whilst taking warfarin
Feverfew	Altered bleeding time reported	Advise patients not to use whilst taking warfarin
Garlic	Case reports of increased anticoagulant effect	Advise patients not to take garlic supplements. Regular  ingestion of foods containing garlic should not pose a  problem
Gingko Biloba	Altered bleeding time, inhibits platelet aggregation	Advise patients not to use whilst taking warfarin
Ginseng	Altered bleeding time	Ginseng contains antiplatelet components so avoid use in    patients taking warfarin
Glucosamine/ chondroitin	Increased risk of bleeding	Chondroitin has anticoagulant activity and should be avoided  in warfarin patients
Green Tea		Documented reports of interactions with warfarin both  increasing and decreasing INR
Liquorice	May increase risk of bleeding
Papaya	Increased bleeding time	Advise patients not to use whilst taking warfarin
Red Clover	May increase effect of warfarin therapy
St John's Wort	Reduction in anticoagulant effect	CSM warning advises patients not to use whilst taking  warfarin
Turmeric	May increase effects of warfarin therapy

 

Side effects and what to expect on Warfarin

You may expect to have prolonged bleeding from cuts or bruises. You may see some blood or bloodstained rinse after brushing of teeth.

 

Exercise

Avoid contact sports and any sport that put you at risk of injury.

 

Alcohol

Should you be a regular drinker you should not consume more than one to two units of alcohol a day.

 

Please call us if you notice any of the following:

• Red or dark urine.
• Tar-like or black stools.
• Vomiting or coughing blood.
• Chest pain.
• Rash.
• Serious fall.
• Stomach pains.
• Increased menstrual blood loss.
• Prolonged headache with double vision or drowsiness.

 

Identification:

You should carry your yellow book with you at all times, this is a record of all your results and medication. If possible wear a bracelet such as a medical alert indicating you are on Warfarin.

 

Please visit the Anticoagulation Monitoring Section for more information about our anticoagulation monitoring services