Precautions for using warfarin

  Warfarin is an anticoagulant taken by many patients with atrial fibrillation and should be used in strict accordance with the physician’s instructions, and INR should be measured regularly. 1-2 times a week for initial outpatients and monthly after stabilization.  1. When blood clots, vomiting of blood, fresh or tarry stools, bleeding gums, blood in sputum, purpura, chest pain, pelvic pain, headache, dizziness, prolonged bleeding after minor trauma or any symptoms of hepatitis (darkening of urine, itchy skin, jaundice, light-colored stools, clay color) occur, the medication should be discontinued immediately and contacted to the physician.  2.Take the medication at the same time every day and should not change the dose or brand of the medication without the doctor’s permission. If you miss a dose of the medication you need to make it up as soon as possible, but you should not increase the dose to make up for it.  3. Do not take other medications, including aspirin and cold medications, without your doctor’s permission. These drugs can interfere with the effects of Warfarin and cause health hazards.  4.Influenza vaccine makes the effect of anticoagulation increase, check for bleeding within one month of vaccination.  5.Fever, climate fever, malnutrition and diarrhea can prolong the clotting time causing bleeding.  6.Maintain a balanced, relatively regular diet and good eating habits, and keep in mind to eat less high-fat diet and foods rich in vitamin K such as: cabbage, cauliflower, asparagus, lettuce, green radish, fish, liver, etc. (See the end of the article) 7. Avoid alcohol abuse. Drinking alcohol can accelerate the metabolism of Warfarin and shorten the bleeding time. Avoid trauma and bleeding as much as possible.  8.Use a soft toothbrush, shave with an electric razor, wear gloves when cultivating flowers and plants, and check with your doctor before participating in sports to see if your physical condition is unfit for exercise.  9, quit smoking or smoke as little as possible, smoking can speed up the metabolism of the drug need to adjust the dosage.  10, Warfarin can cause miscarriage, stillbirth, fetal malformation, if the patient is pregnant or preparing to become pregnant please tell the doctor.  11.Patients should tell their doctor that they are taking Warfarin when they see other diseases, and they must indicate that they are receiving Warfarin treatment.  Foods rich in vitamin K include sour cheese, pork liver, egg yolk, barley, beans, carrots, tomatoes, safflower oil, soybean oil, cod liver oil, seaweed, broccoli, green peppers, garlic, ginger, cauliflower, green leafy vegetables (spinach, rape, alfalfa, lettuce, cabbage) and pears, apples, peaches, oranges, etc. Green leafy vegetables are rich in vitamin K. The vitamin K content per 100 grams of vegetables is 380 mg of spinach, 315 mg of dark green leafy lettuce, and 145 mg of cabbage.  Although foods rich in vitamin K or foods that interfere with vitamin K synthesis can affect the efficacy of warfarin, this does not mean that patients need to completely avoid these foods, but rather need to maintain a relatively balanced diet, taking care to reduce the intake of foods rich in vitamin K (the daily intake of vitamin K for adults is 65 to 80 micrograms), not to mention the need to overly restrict the intake of vegetables low in vitamin K (e.g. onions have fibrinolytic activity and should not exceed 60 grams in 1 day). After all, vegetables and fruits can provide other nutrients that are necessary for the health of the whole organism. Therefore, in order to maintain the stability of the anticoagulant efficacy of warfarin, it is necessary for patients to maintain a relatively balanced dietary structure and not to arbitrarily switch the type and quantity of vegetables while taking the drug.