Author: Danielle Cassidy, Pharm.D., BCPS Description: Educational handout created for families and young adults discharged from the hospital on warfarin therapy.

1. Hematology Clinic
13123 East 16th Ave, B115
Aurora, CO 80045
Office: 720 .777.6578
After hours: 720.777.6740
Generic name: warfarin
Brand name: Coumadin®
[You= you and/or your child]
What is warfarin?
Warfarin is an anticoagulant medicine (“anti” means against and “coagulant” means to thicken or clot) that
helps to reduce the chance of clots from forming in the blood. Warfarin is commonly used to prevent and/or
treat blood clots.
How Does Warfarin Work?
Your liver makes clotting factors by using Vitamin K. These clotting factors help the blood to clot to prevent
bleeding. Warfarin blocks the re-use of Vitamin K in your liver and reduces the body’s ability to make blood
clots.
Warfarin and Your Diet
Vitamin K is found naturally in many foods you eat, so you should be aware of foods that are rich in Vitamin K.
Your diet should include a consistent amount of Vitamin K since consuming too much Vitamin K can decrease
how well warfarin is able to work in your body.
What Are Possible Side Effects of Warfarin?
 Side effects of warfarin may happen and may include bleeding.
 Common/minor bleeding side effects :
o gum bleeding while brushing your teeth
o occasional nose bleeds that stop within a few minutes
o bruising more easily
o bleeding after a minor cut that stops within a few minutes
o Women: menstrual bleeding (“period”) that is a little heavier than usual
 Major/serious bleeding side effects- call the clinic or GO to the Emergency Room if you experience any
of the following:
o excessive or unusual bleeding from o painful swelling of an arm or leg
any part on your body o chest pain or painful breathing
o dark brown or red urine o weakness on one side of the body
o red or black (tar-colored) stools o sudden difficulty speaking
o vomiting blood o sudden changes in vision
o excessive bruising o unusually severe or prolonged headache
o severe stomach pain o yellowing of the skin or eyes
o dizziness

2. How Do I Take My Warfarin?
 Warfarin should be taken once a day at the same time every day.
 The amount of warfarin each person needs is different. Your dose is based on a blood test called the
INR (International Normalized Ratio). The amount of medication you take may change based on this
blood test so it is important to take the dose as directed by The Children’s Hematology Clinic.
 When you take your warfarin, check to make sure you are taking the right dose.
o Does the tablet color match the tablet strength you should be taking?
o Does the number and strength of tablets equal the dose you should be taking?
What Should I Do If I Miss A Dose?
 You should try not to skip any doses of warfarin since this can affect warfarin’s ability to prevent blood
clots.
o If you miss a single dose of warfarin take the medication as soon as you remember. If it is
almost time for the next dose, skip the missed dose and return to your regular schedule.
o If you forget more than one dose of warfarin, contact us as soon as possible. DO NOT take
another dose to “catch up”.
 Keep track of missed doses by writing them in a diary or on your calendar. A pillbox can help you keep
track of your doses.
Warfarin and Your Medications (prescription, over-the-counter, herbal/alternative/nutritional supplements)
 Make sure to tell any other healthcare provider that you are taking warfarin. If you have questions,
contact the clinic.
 Since certain medications can increase the risk for bleeding, so it’s important that you call us as soon
as possible when:
o Starting any new medication OR
o Making any changes in the medications you currently take.
 Avoid other medicines that contain aspirin, ibuprofen (Motrin), or naproxen (Alleve) since they can
increase your risk for bleeding, and possibly interfere with the benefits of aspirin.
 It is okay to use acetaminophen (Tylenol) as needed for pain, fever, or headache.

3. Staying Safe While Using Warfarin
 Always wear a helmet while riding a bike or skateboard, and always wear seatbelts in motor vehicles.
This is especially important while taking warfarin, since injuries can result in more severe bleeding.
 Be careful when using sharp objects such as knives, razors, and scissors that could make you bleed.
 Call us if you are involved in a falls or accidents, especially if you hit your head. Call us even if you feel
fine.
 Inform ALL healthcare providers (physicians, dentists, etc.) that you are taking warfarin, especially
before undergoing any procedures or surgeries.
 Notify the clinic a few weeks before undergoing any procedures or surgeries. A written plan for stopping
warfarin before the procedure/surgery and restarting it afterward will be made by the clinic, and
provided to both you and the healthcare provider who will be performing the procedure/surgery.
 WOMEN
o Contact your healthcare provider immediately if you are pregnant or if you plan on becoming
pregnant. Warfarin can cause serious birth defects and we will need to switch you to a different
medication.
o It is important to use a form of birth control that you can trust while taking warfarin.
3