Warfarin is an anticoagulant (blood-thinning drug) used to prevent blood clots from forming. Clotting (coagulation) of blood is a normal process. Anticoagulants can purposely slow down this process. Warfarin is needed to prevent thrombosis in certain medical conditions and in patients with certain artificial (prosthetic) heart valves. Warfarin is specifically used in valve surgery to prevent the formation of small emboli in the valve. A blood test for clotting time (also called Protime or P.T.) in seconds, which tells how long the blood takes to clot, can determine the amount of warfarin to be used to keep the clotting within the therapeutic range. The therapeutic range for a patient taking warfarin is 1.5-2 times the normal clotting time, which is 12 seconds, and thus most patients receiving warfarin need to have a clotting time between 18-24 (16-20) seconds, a motility between 30–50% (40%–60%), or INR between 2-3 (1.5-2.5) The clotting time will be checked every day during your stay in the hospital. After discharge you can have your clotting time checked every 1-2 weeks. The frequency of clotting time checks can be tapered over 1-2 months after your Warfarin dose has stabilized. You will need to have your clotting time checked every 4-6 weeks for as long as you are taking warfarin. It is important to remember the following rules when taking Favarox 1. Do not take any medications containing aspirin while taking Favarox. 2. Learn to read the label on the bottle. Some cold medicines contain aspirin. 3. Have your clotting time checked immediately if you notice any of the following signs: —- bleeding gums —- nosebleeds —- bloody or black stools —- bloody or strawberry-colored urine —- increased menstruation —- hemoptysis or vomiting of blood —- severe abdominal pain —- severe headache —- excessive petechiae. 4. units to regulate the dose of Warfarin, not by the number of pills 5. Limit alcohol intake to no more than 2 drinks in 24 hours, as alcohol can interfere with the absorption of Warfarin 6. Increase the frequency of monitoring the bleeding and clotting times when taking other medications or when there are dietary changes. There are several manufacturers of Warfarin available. You should choose one and not change it. If you need to change it, you should monitor your clotting blood and adjust it to the appropriate dose. Keep a record of the results of your clotting time and the dose adjustment of Warfarin. When you are discharged from the hospital, the following table can be used as a guide. Date P.T. Results Warfarin Dose Time of Next Blood Test Infection Prophylaxis for Valve Prosthesis Placement Patients with valve replacements require additional infection prophylaxis. The valve prosthesis is an artificial object in the body. Any bacteria that enter the bloodstream can begin to grow around the prosthetic valve. Bacteria growing at the valve can lead to valve malfunction and infection of the endocardium. To prevent infection, antimicrobials are given whenever there is a possibility of bacteria entering the bloodstream. Antimicrobials are given before and after performing the following operations 1. All dental operations, including scaling, fillings and extractions. Encourage regular dental cleanings to maintain good oral hygiene. Tell your dentist before your visit that you are taking Favarine and that short-term discontinuation of it may be necessary. 2. any minor or major surgery 3. any invasive medical operation or examination, as blood vessels may be pierced and bacteria can enter. You may need antimicrobials if you have a fever or have some kind of infection. This includes skin, respiratory, vaginal, and urinary tract infections. Not all colds are caused by viruses, and antibiotics may also be needed to treat colds.