Tanyard Medical Practice 2 Tanyard, Cumnock Side Effects of Warfarin Things to Remember 01290 421157 01290 422723
There are a number of possible side effects with
Dental Treatment
anticoagulants, with the major side-effect of al being
Tel your dentist that you take warfarin, for some
dental treatments you may be required to temporarily stop your warfarin. Your GP/INR Nurse
Passing blood in your urine or faeces (stools)
This may be bright red or darker/black in colourSurgery & Investigations
Heavy bleeding during a period, or other
If you have surgery or an invasive test scheduled
then you may need to temporarily stop your
warfarin. Your GP/INR Nurse wil be able to advise
Anticoagulants: Warfarin Antibiotic Treatment A patients education leaflet
Antibiotics are a group of medication which affects the way in which warfarin works. If you are
If you cut yourself, or have any other bleeding,
commenced on antibiotic treatment, you wil be
INR Clinics you should seek medical help as soon as possible
advised if your warfarin dose requires to be
Tuesday and Thursday mornings if the bleeding does not stop as quickly as you
changed, and you may be asked to attend for
By Appointment Only would expect it to.
monitoring earlier than planned. This is a precaution to ensure that your INR level
Contact your GP practice during working hours.
remains stable throughout the course of treatment.
This leaflet will cover; Contact NHS 24 on 08454 24 24 24 out of hours, over weekends, and on holidays when the practice is closed.
By fol owing the advice given to you by your
Nurse/GP, by taking your warfarin as directed and
by attending to have INR blood tests on time, your
warfarin monitoring should be wel managed. January 2014
If you have any other questions in relation your
warfarin management please discuss at your next
What are anticoagulants? Do I require to have my INR checked out with the What if I have missed a tablet or think I have arranged review times? taken too much?
Anticoagulants are medicines that prevent the blood from clotting as quickly as effectively as normal.
Yes, if you suffer from any of the following
If you accidental y miss a dose, NEVER, take a double dose to “catch up” unless you are specifical y
Some people cal anticoagulants blood thinners.
1. Bleeding
advised to do so by your GP or the INR Clinic Nurse.
However, the blood is not actual y made thinner – it
2. Change in medication
just does not clot so easily whilst you take an
3. Unwell, e.g. a fever
If you think that you have taken too much warfarin by
mistake or have missed any doses please contact
You wil be requested to re-attend to have your INR level
your GP practice for advice during working hours. If
Blood clotting of the artery or vein can lead to DVT,
you require to speak to someone out of hours or over
a weekend, please contact NHS 24 on 08454 24 24
Our practice has a dedicated INR clinics that run two
Anticoagulants are prescribed if you have already had mornings each week, on a Tuesday and a Thursday. a blood clot (treatment) – to prevent the clot from getting bigger, or if you are at risk of having a blood
This clinic is by appointment only and is taken by
Drug Interactions
Almost al medications can interact with warfarin, for
You wil have your blood taken by one of our Practice
Warfarin Monitoring
example antibiotics, pain kil ers and herbal remedies.
Nurses using the CoaguChek® machine. The Nurse wil
This can change the way in which it works and your
inform you of your INR level, what dose of warfarin to
dose may need to be altered. It is therefore important
When you first start warfarin, your GP or Hospital
take, and when you should arrange your next
to let your doctor, nurse and pharmacist know that
Consultant wil advise you on how to take warfarin,
you are taking warfarin before buying over the counter
the risks involved, things that can interact with
warfarin and where you can attend for monitoring.
If you are a house bound patient, it wil be arranged for a member of the District Nurse team to visit you at home
Food Interactions What is INR?
to perform your INR level check. If you have not heard from the practice by 5pm that day, please cal the
INR is a measurement of how long it takes for blood
surgery for your result and dose advice.
A major change in diet may require closer monitoring
to clot. This varies depending on the il ness being
and a change to your warfarin dose. Some foods
treated, but the maximum therapeutic range is 4.
Al warfarin patients should update and carry their yel ow
contain Vitamin K, which can decrease the effect of
anticoagulant treatment book with them, which wil be
warfarin. There are large amounts of vitamin K in certain foods such as liver, broccoli, brussels sprouts
How often should I have my INR checked?
given to you when you first start. This is in case of emergencies, should a doctor need to know that you are
and green leafy vegetables such as spinach coriander and cabbage and even some cheeses. Two other
Once your INR level is stable, we aim towards the
commonly eaten foods that are known to interact with
longest interval possible between monitoring, unless
you are at high risk of bleeding, then a maximum
Should I stop Aspirin if I start Warfarin?
This depends on each individual patient and their relevant il nesses. Please discuss this with your GP who wil be able to advise.
Gobernanza y cambios territoriales Experiencias comparadas de migración de amenidad en las Américas. Michael Janoschka Investigador Ramón y Cajal Departamento de Ciencia Política y Relaciones Internacionales Universidad Autónoma de Madrid c/Marie Curie 1 E-28049 Madrid E-Mail: michael.janoschka@uam.es Web: http://www.michael-janoschka.de Actos de ciudadanía - Espaci