Monday, 18 April 2016

Knowing how to live well with the unknowns of Warfarin

Warfarin is an anticoagulant drug. It can help prevent blood clots from forming in the blood vessels.
 Warfarin is given to people :
  • with deep vein thrombosis (blood clots in the veins of the legs)
  • with pulmonary embolism (a blood clot in the lungs)
  • with a condition that increases the risk of a blood clot developing, such as atrial fibrillation
  • with a prosthetic (replacement or mechanical) heart valve
  • who have had a heart attack  
People taking warfarin need blood tests every 4–8 weeks. If the blood tests show that warfarin is not working properly, then a different dose will be needed. If people just starting to take warfarin, blood tests may be needed more frequently until the INR (International Normalised Ratio) becomes stable.

 The blood needs vitamin K to be able to clot. Warfarin slows the production of vitamin K in the body, which increases the time it takes for your blood to clot. Warfarin helps your blood to flow freely around your body and stops any clots forming in the heart or in the blood vessels.
Warfarin reduces the ability of your blood to clot. This means you have to be careful when doing exercise. Even minor injuries or small knocks could result in bleeding or bruising.
Other medicines you may be taking may affect how your warfarin works. This includes alcohol, medicines bought without a prescription and herbal medicines.
Because vitamin K and warfarin tend to work against each other, it is important to be aware that changes in diet can have an impact on warfarin activity within the liver. As vitamin K is essential for a healthy diet you should not try and eliminate vitamin K from your food intake. It has actually been suggested that people with more vitamin K in their diets may find it easier to keep their INR within their ‘target range’ than people with a lower vitamin K intake. Aim to balance your vitamin K intake by being consistent with the foods that you eat.
High amounts of Vitamin K are generally found in green leafy vegetables, such as spinach, broccoli, Brussel sprouts, parsley, silverbeet, endive and kale. 

In contrast, all breads, cereal grains and their milled products, nuts, most fruits and their juices, fish, meat, chicken, pork, tofu, eggs, dairy products, fats and oils, roots and tubers contain low quantities of Vitamin K.
Drinking large amounts of cranberry and  grapefruit juice may increase the risk of bleeding in some people taking warfarin. However, drinking 250 ml (1 cup) or less of the juice is unlikely to affect your INR or pose any risk of bleeding.

Smoking, in general, increases the risk of blood clot formation, causes or worsens other health conditions, and should be discouraged.
Warfarin and painkillers :
  • do not take aspirin or drugs that contain aspirin because this could lead to bleeding 
  • do not take ibuprofen
  • you can take paracetamol but do not take more than the recommended dose 
You might find useful a Medical band, if you are taking Warfarin. It is a simple solution to communicate critical information when you can´t.

Pregnancy and Warfarin

Warfarin passes from mother to baby across the placenta and can interfere with normal blood clotting in the baby. Warfarin can also interfere with the formation of bone and cartilage in the developing embryo. These effects on blood clotting and embryo development can lead to birth defects and other problems. A woman who becomes pregnant or plans to become pregnant while on warfarin therapy should notify her healthcare provider immediately. Heparin, another anticoagulant, does not cross the placenta from mother to baby and is usually used instead of warfarin during pregnancy. Warfarin can be restarted after delivery.
Breastfeeding and Warfarin
Although warfarin does not pass into breast milk, a woman who wishes to breastfeed while taking warfarin should consult her healthcare provider. Warfarin is considered safe for use in women who breastfeed.

Contraception and Warfarin

If you are taking warfarin, you should avoid all estrogen-based forms of contraception, such as oral contraceptive pills and products. Oral contraceptives reduces effect of warfarin and must be avoid in thromboembolic disorders.

Warning: Health information and the names of the drugs mentioned in the article are only for orientation in the field of self-medication and does not replace communication with your doctor. Before taking any medication, read the leaflet or ask your pharmacist or doctor. The author is not responsible for misinterpretation of the information contained on the website and is not responsible for any damages incurred subsequent procedures or conduct that are made based on the content of these pages. By entering this blog you confirm that you have read the aim and the restrictions of the site.