Coumdain information and side effects from Elaine and James. Two members of our mailing forum

Tell all medical doctors, dentists, and pharmacists you go to that you are taking this medicine.

Check with your doctor right away if you notice any unusual bleeding or bruising.

Check with your health care professional before you start or stop taking any other medicine, or change the amount you are taking . This includes any non-prescription (over-the-counter [OTC]) medicine, even aspirin or acetaminophen. Many medicines change the way this medicine affects your body. You may not be able to take the other medicine, or the dose of your anticoagulant may need to be changed.

It is important that you carry identification stating that you are using this medicine. If you have any questions about what kind of identification to carry, check with your health care professional.

While you are taking this medicine, it is very important that you avoid sports and activities that may cause you to be injured. Report to your doctor any falls, blows to the body or head, or other injuries, since serious internal bleeding may occur without your knowing about it.

Be careful to avoid cutting yourself. This includes taking special care in brushing your teeth and in shaving. Use a soft toothbrush and floss gently. Also, it is best to use an electric shaver rather than a blade.

Drinking too much alcohol may change the way this anticoagulant affects your body. You should not drink regularly on a daily basis or take more than 1 or 2 drinks at any time. If you have any questions about this, check with your doctor.

The foods that you eat may also affect the way this medicine affects your body. Eat a normal, balanced diet while you are taking this medicine. Do not go on a reducing diet, make other changes in your eating habits, start taking vitamins, or begin using other nutrition supplements unless you have first checked with your health care professional. Also, check with your doctor if you are unable to eat for several days or if you have continuing stomach upset, diarrhea, or fever. These precautions are important because the effects of the anticoagulant depend on the amount of vitamin K in your body. Therefore, it is best to have the same amount of vitamin K in your body every day. Some multiple vitamins and some nutrition supplements contain vitamin K. Vitamin K is also present in green, leafy vegetables (such as broccoli, cabbage, collard greens, kale, lettuce, and spinach) and some vegetable oils. It is especially important that you do not make large changes in the amounts of these foods that you eat every day while you are taking an anticoagulant.

Check with your doctor if you are unable to eat for several days or if you have continuing stomach upset, diarrhea, or fever. This could decrease the amount of vitamin K that gets into your body and could affect this medicine. Be careful if the weather is very hot for several days. This could increase the effects of the medicine. Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention. Since many things can affect the way your body reacts to this medicine, you should always watch for signs of unusual bleeding.

Unusual bleeding may mean that your body is getting more medicine than it needs. Check with your doctor immediately if any of the following signs of bleeding or overdose occur:

• Bleeding from gums when brushing teeth
• blood in urine
• nosebleeds
• pinpoint red spots on skin
• unusual bleeding or bruising
• unusually heavy bleeding or oozing from cuts or wounds
• unusually heavy or unexpected menstrual bleeding.
• Signs and symptoms of bleeding inside the body dose-related Abdominal or stomach pain or swelling
• back pain or backaches
• black, tarry stools
• bleeding in eye
• blood in stools
• blood in vomit or vomit that looks like coffee grounds
• blood in urine
• blurred vision
• chest pain
• confusion
• constipation
• coughing up blood
• diarrhea (sudden and severe)
• dizziness or fainting
• headache (continuing or severe)
• joint pain, stiffness, or swelling
• loss of appetite
• nausea and vomiting (severe)
• nervousness
• numbness or tingling of hands, feet, or face
• paralysis
• shortness of breath, weakness (sudden)

Also, check with your doctor as soon as possible if any of the following side effects occur:

Less common
• Cough or hoarseness
• fever or chills
• lower back or side pain
• painful or difficult urination
• skin rash, hives, or itching
• Rare Blisters or itching on skin
• blue or purple toes
• dark urine
• pain in toes
• painful red sores on skin especially on thighs, breasts, penis, or buttocks
• sores, ulcers, or white spots in mouth or throat
• sudden increase or decrease in amount of urine
• swelling of face, feet, and/or lower legs
• trouble in breathing
• yellow eyes or skin

Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome: Less common or rare Bloated stomach or gas (with dicumarol), cold intolerance, diarrhea (more common with dicumarol) , loss of appetite, nausea or vomiting (more common with dicumarol), stomach cramps or pain These medicines sometimes cause temporary loss of hair on the scalp.

Depending on your diet, anisindione may cause your urine to turn orange. Since it may be hard to tell the difference between blood in the urine and this normal color change, check with your doctor if you notice any color change in your urine.

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor

Yup there is the dizziness

For the newer people reading, I would like to provide a different view point on one area. It is possible to live a normal life on coumadin / warfarin. We can (and many here do) play sports, do athletic activities, shave with a blade etc. What we on warfarin must remember is that we ARE at an increased risk for bleeding, and internal is particularly insidious. However, we do not always bleed heavily. As an example, I hit my leg with an axe and only bleed like a "normal" person, in the past without warfarin I have clotted a similar wound within a 1/2 hour.

The biggest issue is that the higher your INR the more you will bleed! I suspect that a lot of the precautions given to us, are the result of concern for high INR as a result of INR fluctuations "the dance". I believe, that home self testing with dose adjustment is the best solution as it allow us to limit the "dance". NOTE: Need physician help or a significant amount of training from a physician to change dose

We all react differently to warfarin. Some have uncomfortable side effects, others have little or no side effect. Taking warfarin is all about risk management, some are more concerned with the affect of clots and chose warfarin for life after one episode. Others use natokinese (sp?) or other methods. We all must learn and make the choice that is best for us.