Coumadin: General guidelines
Don't Mix Other Medicines 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 medicine could potentially affect your Coumadin® control. It is important to recheck your Pro-Time whenever starting or stopping any other medicine. Aspirin is the most common drug which affects Coumadin® regulation. Alcohol, antacids, antihistamines, antibiotics, and many other common medications also affect Coumadin®. A full list of medications which are known to interfere with Coumadin is included in this Learning Center presentation.
Follow a Schedule
Take your pill 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 that 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 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 ID 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 checkups to prevent, and treat, gum disease that might predispose to bleeding during brushing or flossing.
Special Precautions
Avoid traumatic sports, if possible. Wear protective head gear for activities like bicycle or horseback riding. Use a soft toohbush to prevent gum injury. Use an electric razor rather than a straight or blade razor. Wear gloves when 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 doctor is using to treat your condition. And continue to have your blood draws as directed by your physician and/or nurse. After each blood draw, keep in touch with your doctors office 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 physician:
- Nose bleeding
- Bleeding gums
- Red or brown urine
- Red or black stools
- Cuts that do not stop bleeding
- Bruises that enlarge
- Excessive menstrual flow
- Headaches or abdominal pain
- Faintness, dizziness, or unusual weakness
Additional Coumadin Sections:
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