What does warfarin patients should know?
What is the recommended timing to take your warfarin?
Take your warfarin dose at 6pm in the evening because it is easier to remember to take your dose after your dinner. Another reason could be, there might be lesser risk of bleeding at evening time. This is because most people will only rest and chill with their family or friends at any time after 6 pm, instead of working or doing labour work. However, if 6pm is not convenient for you, just take at the time most suitable for you as long as you take at a consistent timing and least likely to miss dose.
What do you do when you miss your warfarin dose?
Let’s say you usually take your warfarin at 6pm in the evening, but you missed it today. You only remember at 10pm at night. You still can take the warfarin dose as usual. Any missed dose less than 8 hours is considered acceptable. If it’s already exceed 8 hours, just skip today dose and continue tomorrow dose as usual.
The INR target for different medical conditions:
- Atrial Fibrillation: 2.0 - 3.0
- Replacement of Heart Valve: Varies depending on the types of valve.
- Deep Vein Thrombosis Prophylaxis: 2.0 – 3.0
- Treatment for Deep Vein Thrombosis or Pulmonary Embolism: 2.0 – 3.0
- Prevention of Blood Clots Formation During Surgery (High Risk Patient): 2.5 -3.5
These recommended INR target range is the “safe level” for the warfarin patients.
Any INR levels less than 2.0 means that the risk of unusual blood clots formation in intact blood vessels is high. Any INR levels more than 3.0 means that the risk of prolonged bleeding is high.
Thus, the frequent INR blood test, especially when a warfarin regimen is newly started or changed is of utmost important to ensure patients do not experience more serious complications or side effects.
As you may know, bleeding is one of the largest concern/side effects of warfarin. So, what types of bleeding or when should I seek treatment immediately? The following are some of the examples:
- Bleeding from cuts than is heavier or longer than usual
- Bleeding nose
- Bleeding gum (not stopping even after 30 minutes)
- Coughing of blood or vomitus contains blood
- Frequent bruises of unknown reasons
- Dark-coloured urine of urine contains blood
- Dark-coloured faeces
- Menstruation that is heavier or longer than usual
Besides from the bleeding side effects, the following are some of the side effects that you should inform your healthcare professionals as well:
- Breathing difficulties
- Chest pain
- Swollen ankles/leg
Speaking of warfarin diet, foods will affect warfarin regimen/INR levels because vitamin K play an important role in the blood clotting process. Foods, especially green leafy vegetables contains a high content of vitamin K.
Some examples of food high in vitamin K:
- Broccoli
- Romaine lettuce
- Brussels sprouts
- Cabbage
- Bitter guard
- Onion leaf
- Soy bean products
- Mustard
- Animals liver
Example of foods low in vitamin K:
- Red carrot
- Cucumber
- Onion
- Corn
- Tomatoes
- White carrot
- Cauliflower
- Brinjal
- Capsicum
- Mushroom
- Bean sprouts
Regardless of food high or low in content of Vitamin k, warfarin patients still can take it as usual. BUT, make sure to take at a CONSISTENT PORTION on an EVERYDAY BASIS. Coffee drinks doesn’t affect INR reading much. However, tea lovers have to take note to drink tea at consistent level everyday.