What is Coumadin®?

Coumadin® is an anticoagulant. It increases the time it takes for your blood to clot. Coumadin® can cause you to be more prone to bleeding, so it is very important for you to have just the right amount of Coumadin® in your body.

Who takes Coumadin®?

Patients who are at increased risk for developing blood clots such as patients with arrhythmias such as atrial fibrillation, new heart valves (either tissue or mechanical) or those at increased risk for stroke.

How do you know you are receiving the right amount of Coumadin®?

  • While you are in the hospital your doctors and nurses will be checking a blood test called a prothrombin time (also known as a "PT"). This test tells the medical team how well your dose of Coumadin® is working for you.
  • Your dose of Coumadin® is changed based on your PT result. Close monitoring of your blood work will keep the amount of Coumadin® in your body just right.
  • Two prescriptions will be give to you on discharge:
    • Coumadin® dose prescription
    • Blood work (PT level) prescription to be drawn by an outside provider.

Who will be following my Coumadin® dosing?

  • Your blood will be drawn at your primary doctor's office or lab close to your home. If the blood is drawn at a lab, the results should be faxed to your cardiologist who will follow the blood work, and dose your Coumadin®.
  • Initially, your PT level will be drawn about 2 times per week and less often once your level is regulated.
  • If you do not think that you will be able to get to the appointments for blood work due to your illness or transportation issues, let your social worker know before the day of discharge. They may be able to assist you.

How is Coumadin® dispensed?

  • Coumadin® is always taken ONCE A DAY AT BEDTIME. There are several reasons for this:
    1. The medication is released over 24 hours, and taking it at the same time will keep your blood level stable.
    2. You will be less likely to forget to take the pill if you take it at the same time each day.
  • If a pill is missed, take the dose when you remember, and call your cardiologist. DO NOT DOUBLE UP DOSES.

Things that can affect the levels of Coumadin® in your body:

  • Aspirin products (unless prescribed by your physician) also act as an anticoagulant, and may alter your PT level. Take Tylenol for pain if needed.
  • Vitamin K is found in many foods you eat, and helps your body form clots. Many fruits and vegetables have moderate to high amounts of Vitamin K—see your Coumadin® book for food lists. You do not have to cut out vitamin K from your diet! Keep eating the food you normally eat—don't make any dramatic changes. If you keep your diet the same, your PT level will not be affected.
Call your cardiologist immediately if you have any of these signs of bleeding! They may be a sign that your Coumadin® level is too high.
  • Nosebleeds or bleeding gums.
  • Spontaneous bruising.
  • Blood in urine and red or tarry stools.

Other precautions to take while on Coumadin®:

  • Call your cardiologist immediately if you fall and hit your head.
  • If you get a cut, hold pressure at the site—you will bleed longer than usual. If the bleeding does not stop, call your cardiologist. If the bleeding is severe, go to the nearest Emergency Room.
  • Keep your Coumadin® ID card in your wallet at all times. Let all health care providers know that you are taking Coumadin®, and well as all other medications.
  • It is a good idea to wear a Medicalert bracelet to alert healthcare providers that you are on Coumadin®. These may be ordered at any local pharmacy.
  • Avoid use of alcohol.
  • Keep your activity level consistent.
  • Do not miss any of your scheduled blood tests!
  • Pills are scored and can be cut in half easily. You may need to take alternating doses each day, and keeping a calendar or pillbox may help you stay organized, and prevent any mistakes.

This resource provides brief, general information about this health care topic. It does not take the place of advice from your heath care provider. Call your provider for additional information.

Copyright NewYork-Presbyterian Hospital 2001. All rights reserved.