How to Live with Warfarin

Warfarin, also known by its brand name Coumadin, is a common anticoagulant (blood thinner) prescribed for people with various cardiovascular diseases, those who've suffered a heart attack, or people with artificial heart valves. This medication prevents blood clots from forming, either in a vein (venous thrombosis) or in the lungs (pulmonary embolism) by decreasing the body's ability to clot blood. If you've been prescribed warfarin, you should be aware of the lifestyle changes you'll have to adjust to in order to maximize the effectiveness of the therapy.


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    Understand precisely your dosages and the time and day you take it. Many people on warfarin are given two different dosages and must take them on alternating days. For example, one may take 2 mg every Monday, Wednesday and Friday, and 3 mg every Tuesday, Thursday, Saturday, and Sunday. Be sure to take the dosage at the required time.
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    Know the sides effects of warfarin and how to handle them. The most common side effect is bleeding (see next step). Other side effects are tiredness, nausea, vomiting, and loss of appetite.
    • A serious side effect is necrosis (death of skin or other body tissues. If you notice a darkened colour to your skin, other skin changes, sudden severe pain, or if your extremities become painful or dark, call a doctor and get medical attention immediately.
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    If you're bleeding, apply more pressure for a longer period of time. Because warfarin decreases your ability to clot blood, it will take longer than usual to stop bleeding. Continue adding direct pressure to the wound.
    • Check for signs of internal bleeding. Check your urine and stool every time you go to the bathroom for the presence of any blood (pinkish, red, or brown urine, bloody or red stool). Inspect your entire body for bruises, especially if you've been injured.
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    Make changes to your diet by limiting foods and beverages high in vitamin K. Warfarin works by interfering with clotting factors dependent on vitamin K. In other words, having a high-vitamin-K diet can negatively affect the way warfarin clots your blood.
    • You do not necessarily need to avoid vitamin K altogether. The important thing is to have a consistent diet that contains balanced amounts of vitamin K.
    • Examples of foods high in vitamin K: dark green, leafy vegetables (for example, spinach, kale, broccoli, Brussels sprouts), green tea, liver, cauliflower.
    • Limit the amount of alcohol you drink. Small amounts are okay.
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    Avoid taking other medications that may interact with warfarin. This includes prescription, over-the-counter, vitamins, and herbal medicines. Ask your doctor before taking new medications or inform your pharmacist that you're taking warfarin before buying OTC medications.
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    Go for regular blood tests to check your INR/prothrombin time. This is a test done in a medical lab to see how well the warfarin is "thinning" your blood. For most people, a normal INR is between 2 and 3, but it may depend on your dosages. After the blood work, your doctor may phone you the results. If it's out of your normal range, consider changing your diet or following up with the doctor to adjust your dosage.
    • The reason for this test is because there is a small window for warfarin to efficiently work. If your INR is too high, your dose may be too much and you could be more prone to severe bleeding. If your INR is too low, however, the dose may be too little and you could risk getting a blood clot in your veins or lungs.
    • The frequency of these tests will change as your body becomes more accustomed to the therapy. When you've just been prescribed the medication, your doctor may order blood tests every day. As you get more and more used to warfarin, you may only need to get a blood test every month.
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    Wear a medical necklace/bracelet that says you are on the anticoagulant warfarin. In case of a medical emergency that requires a 911 call (call to Emergency services), this alerts EMTs that you're on warfarin so that they don't give you medications that could possibly interact harmfully with it. Also, tell your dentist that you're taking warfarin before undergoing any dental procedure.


  • Breastfeeding is safe to do.
  • If you miss a dose within a few hours, take it once you remember.
  • Avoid rough contact sports such as football or wrestling that make you prone to injury.


  • Do not take aspirin, ibuprofen (Advil, Motrin), or naproxen (Aleve) for painkillers. These and other NSAIDs can greatly increase your bleeding risk. Take acetaminophen (Tylenol) instead.
  • Never double-dose if you miss a dose. This can increase your chances of bleeding.
  • Watch your alcohol intake. While studies have shown that 1-2 glasses of red wine can improve heart health, alcohol is one of the substances that can harmfully interact with warfarin, causing severe symptoms like internal bleeding. Talk to your doctor before consuming alcoholic beverages.

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