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Coumadin Warnings and Precautions

Specific Precautions and Warnings With Coumadin

Warnings and precautions to be aware of prior to taking Coumadin include the following:
 
  • While it can be a life-saving drug, the side effects of Coumadin can be life-threatening. Even small changes in the dosage (or drug interactions or dietary changes) can lead to dangerous problems. Taking too little Coumadin, which can increase the risk of blood clots and strokes, can be just as dangerous as taking too much, which can increase the risk of dangerous internal bleeding.
     
  • Close monitoring, using a blood test known as the international normalized ratio or INR, is essential for safe use of Coumadin. As long as you take this drug, your INR will need to be monitored frequently.
     
  • Many medications and some foods interact with Coumadin (see Coumadin Drug Interactions and Coumadin Diet). Such interactions can lead to dangerous consequences if not handled properly. Check with your healthcare provider before starting or stopping any medication or supplement, or even when adjusting the dosage of any medication or supplement.
     
  • One of the most serious side effects of Coumadin is internal bleeding, which can be fatal. Let your healthcare provider know if you develop any signs of bleeding, such as:
 
    • Easy bruising
    • Cuts or scrapes that are slow to stop bleeding
    • Black, tarry stools; bright red blood in the stool; or vomiting of blood (signs of gastrointestinal bleeding)
    • Signs of bleeding in the brain, such as vision or speech changes, weakness or numbness in an arm or leg, or a severe headache.
 
  • Although Coumadin is used to prevent and treat blood clots, people just starting treatment may actually be at an increased risk for blood clots, which can lead to tissue death (gangrene) and fatal outcomes. Coumadin decreases certain anticoagulant proteins before it starts working to prevent clots; this temporarily increases the risk for blood clotting. In some cases, your healthcare provider might recommend "bridge therapy" with heparin or a heparin-like medication temporarily when you first start taking Coumadin.
     
  • For some people, the risks of taking this drug are greater than the possible benefits. These people should not be prescribed Coumadin.
     
  • Let your healthcare provider know if you develop a "purple toe" while taking Coumadin. This is a potentially serious problem that can lead to toe amputation.
     
  • Coumadin, warfarin, warfarin sodium, and Jantoven® are different names or brand names for the same medication. Accidental overdoses have occurred because people did not realize that these were the same medications.
     
  • Make sure that each of your healthcare providers is aware that you are taking Coumadin. Be sure to carry information that identifies you as a Coumadin patient (this could be a wallet card or a medical bracelet).
     
  • Before any surgery or procedure, make sure to ask your healthcare provider if you should temporarily stop taking Coumadin.
     
  • If you are breastfeeding or plan to start, discuss this with your healthcare provider prior to taking the drug (see Coumadin and Breastfeeding for more information).
     
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