Warfarin Counseling
Clinic Patient Education
The UCSD Anticoagulation Clinic
 The UCSD Anticoagulation clinic is run by
pharmacists
 The 2 clinic locations
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Hillcrest: 330 Lewis Street (@ 4th Ave)
La Jolla: 9350 Campus Point Drive
(@ Perlman Medical offices)
 Contact information and important phone
numbers are listed in your handout
Warfarin / Coumadin®:
What it is and What it Does
 What is warfarin?
 An anticoagulant that helps reduce the
formation of clots in your blood
 Why was warfarin prescribed for you?
 Sometimes medical conditions can make
blood clot too easily and quickly
 This could cause serious health problems
because clots can block the flow of blood to
the heart or brain
 Warfarin can prevent harmful clots from
forming
Warfarin / Coumadin®:
What it is and What it Does
 How does warfarin work?
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Blood clots are formed through a series of
chemical reactions in your body.
Vitamin K is necessary for those reactions.
Warfarin works by decreasing the activity of
vitamin K which lengthens the time it takes for
a clot to form
How to Take Warfarin
 Take warfarin at the same time every day as
directed by the Anticoagulation Clinic.
 Warfarin can be taken with food or other
medications.
 If you forget a dose, take it as soon as you
remember, as long as it is the same day.
 Never skip a dose or take a double dose.
Blood Tests
 How much warfarin you need will depend
upon the results of your blood tests
 The International Normalized Ratio (INR) is
the blood test we will use to evaluate how
long it takes your blood to clot
 You will need to get your INR checked
regularly as directed by the Anticoagulation
Clinic
Blood Tests
Possible Side Effects of Warfarin
 Warfarin is very well tolerated
 Minor bleeding is the most common
complication and is not dangerous
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Gum bleeding
Occasional nosebleeds
Easy bruising
Heavier than normal menstrual bleeding
Bleeding that takes longer to stop than usual
 Most people will experience one or more of
these effects
Possible Side Effects of Warfarin
 Major bleeding is a rare but serious side
effect that must be reported immediately
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Red or brown urine, red or tarry stools
Blood in vomit or phlegm/mucus
Severe headache or stomachache
Prolonged or excessive bleeding
Large unexplained bruises
 If you sustain a serious fall or injury or hit
your head at any time, go directly to the
emergency room!
Using Other Medications:
Over-the-Counter Products
Pain medications
 Medications you may use

Acetaminophen (Tylenol®): no more than 2000 mg per
day
 Medications to avoid
 Ibuprofen (Advil®, Motrin®, Nuprin®)
 Naproxen (Aleve®, Anaprox®, Naprosyn®)
 Aspirin (Ecotrin®, Bayer®), unless prescribed by your
doctor
 Other products that may contain aspirin or aspirin-like
products: Excedrin®, Alka-Seltzer®, Pepto-Bismol®
Using Other Medications:
Over-the-Counter Products
 Vitamins
 Multi-vitamins containing vitamin K should be taken
consistently
 Herbal products to avoid
 Danshen
 Garlic
 Ginkgo
 Ginseng
 Fish oil
 Kava kava
 Omega-3 fatty acids
 Check with the Anticoagulation Clinic before
starting any new medication
Using Other Medications:
Prescription Medications
 Medications that may have a strong interaction
with warfarin:
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Antibiotics (e.g. Septra®/Bactrim®, Flagyl®, Diflucan®)
Cardiovascular medications (e.g. amiodarone)
Anticonvulsants (e.g. Dilantin®, Tegretol®)
 Let your pharmacist or doctor know every time
you start a new medication. This will allow
them to evaluate whether your warfarin could
interact with this new medicine.
Diet for Warfarin Users
 The food you eat can affect how warfarin
works
 To help warfarin work effectively, it is
important to keep your vitamin K intake as
consistent as possible

The highest amount of vitamin K is found in
green, leafy vegetables like broccoli
 Alcohol should be limited to 1 drink per day
 Avoid eating mangos and liver
How Taking Warfarin Changes
Your Life
 Activity: Stay active, but use protection when
at risk for injury.
 Diet: Keep it balanced and consistent. We will
adjust the warfarin to your diet and lifestyle.
 Alcohol: Limit to 1 drink per day.
 Healthcare: Attend all Anticoagulation Clinic
visits. Inform all healthcare providers
(including us) of all medications and illnesses.
 Pregnancy: Do not take warfarin if you are
pregnant or may become pregnant.
Questions?
 Please fill out the Medical History form—front
and back
 We will review your medicines and history
and perform the INR test at your appointment
 We hope this session was informative
 Thanks for coming!