What Cough Medicine Can You Take With Warfarin

1. Almost warfarin

Warfarin is a type of medicine known equally an anticoagulant, or blood thinner.

It makes your claret flow through your veins more than easily. This ways your blood will be less probable to make a unsafe blood clot.

Warfarin is used to treat people who have had a previous blood jell, such equally:

• a blood clot in the leg (deep vein thrombosis, or DVT)
• a blood clot in the lungs (pulmonary embolism)

It's also used to prevent blood clots if you're at high gamble of having them in the hereafter.

This includes people with:

• an abnormal heartbeat (atrial fibrillation)
• a replacement or mechanical heart valve
• a blood clotting disorder, such as thrombophilia
• a higher chance of having a blood jell after an operation

Warfarin is only bachelor on prescription. It comes as tablets and every bit a liquid that you eat.

NHS coronavirus advice

When taking warfarin, you need to have regular blood tests. It's important to keep having these tests at the times yous're brash during coronavirus.

Information technology'due south also important to tell your doctor straight abroad if you have warfarin and have tested positive for coronavirus or have coronavirus symptoms.

Updated: 15 Oct 2020

2. Key facts

• It'due south usual to take warfarin once a day, ordinarily in the evening.
• The chief side effect of warfarin is haemorrhage more easily than normal, such as having nosebleeds, bleeding gums, heavier periods and bruising. This is most likely to happen in the starting time few weeks of treatment or if you're unwell.
• Yous need to have claret tests at least every 12 weeks while yous're taking warfarin to brand sure your dose is right.
• Expect your warfarin dose to go up or down. This is normal. The dose can depend on lots of different things, including what you eat and drink, what other medicines you're taking, and if you get unwell.
• Always carry your anticoagulant alert menu with you. Show it to your physician or dentist earlier y'all have any medical or dental procedures, including vaccinations and routine appointments with the dental hygienist.

three. Who tin can and tin can't take warfarin

Warfarin tin be taken past adults and children.

Warfarin is not suitable for some people. Tell your doctor if yous:

• accept had an allergic reaction to warfarin or any other medicines in the past
• are trying to get pregnant or you're already pregnant - warfarin can be harmful to the baby
• accept liver or kidney bug
• have had an infection of the lining of your heart known as endocarditis
• have a health problem that causes bleeding (such as a stomach ulcer) or makes you bruise easily
• take loftier blood pressure
• are taking the herbal remedy St John'south wort for depression

4. How and when to take it

Dosage and force

The usual warfarin dose is 10mg a 24-hour interval for the first 2 days, then between 3mg and 9mg a day after that.

Warfarin tablets come up in four different strengths. The tablets and the boxes they come in are different colours to brand information technology easier for you to have the right dose.

The strengths and colours are:

• 0.5mg – white tablet
• 1mg – chocolate-brown tablet
• 3mg – bluish tablet
• 5mg – pink tablet

Your dose may exist made upwards of a combination of different coloured tablets.

Warfarin also comes as a liquid, where 1ml is equal to a 1mg (dark-brown) tablet.

Warfarin liquid comes with a plastic syringe to assist you measure the right amount.

How to have information technology

Information technology's very important to have warfarin every bit your doctor advises. Take it in one case a twenty-four hours at about the aforementioned time.

Information technology'south usual to take warfarin in the evening. This is and so that if you lot need to change the dose after a routine blood test, y'all tin can exercise this the same day rather than waiting until the following morning.

Warfarin does not commonly upset your stomach, so y'all can take it whether yous have eaten recently or not.

How long to accept it for

If you have had a blood clot in your leg or lungs, you'll probably have a short course of warfarin for 6 weeks to 6 months.

If you take warfarin to reduce your hazard of having a blood clot in future or considering you keep getting claret clots, it's likely your treatment will be for longer than 6 months, maybe even for the residual of your life.

Will my dose go up and downwards?

Your warfarin dose may change often, especially in the first few weeks of treatment, until your doctor finds the dose that'due south right for you lot.

Why exercise I accept blood tests?

The aim of treatment with warfarin is to sparse your blood just not cease it clotting completely. Getting this balance right means your dose of warfarin must be advisedly monitored.

Y'all'll have a regular blood exam called the international normalised ratio (INR). It measures how long it takes your blood to clot. The longer your blood takes to clot, the higher the INR.

Well-nigh people taking anticoagulants accept a ratio of between two and 3.five. This means their blood takes two to 3.5 times longer to jell than usual.

The dose of warfarin you lot need depends on your blood test effect. If the blood test result has gone upward or downwards, your warfarin dose will be increased or decreased.

You lot'll have the blood tests at your GP surgery or local hospital's anticoagulant dispensary.

If your blood exam results are stable, you might only need a claret test in one case every 8 to 12 weeks. If information technology's unstable or y'all have merely started on warfarin, you might need to have a claret test every week.

The yellow book and alert bill of fare

When you starting time taking warfarin, you may exist given a yellowish book about anticoagulants.

This explains your handling. In that location's also a section for yous to write downward and continue a record of your warfarin dose.

It'south a adept idea to take your yellowish volume with you lot to all your warfarin appointments.

You'll also be given an anticoagulant alert card. Deport this with y'all all the time.

It tells healthcare professionals that you're taking an anticoagulant. This can be useful for them to know in case of a medical emergency.

Example of front of anticoagulant alert card

Example of back of anticoagulant alert card

If you lot need any medical or dental treatment, prove your anticoagulant alert carte du jour to the nurse, doctor or dentist beforehand.

This includes before you have vaccinations and routine sessions with the dental hygienist.

Your doctor may advise you to stop taking warfarin or reduce your dose for a short time before your treatment.

If you have lost your warning carte or were not given one, ask your md or anticoagulant clinic.

What if I forget to take it?

It'southward important to attempt to recall to take your warfarin on time.

It's non a problem if yous occasionally forget to take a dose at the correct time.

But if you forget often, your claret could be afflicted – it might get thicker and put you at adventure of having a blood clot.

If you lot miss a dose of warfarin, write it down in your yellowish book.

Accept the missed dose equally soon as you call up.

If y'all practise non remember until the next day, skip the missed dose and accept your normal dose at the usual fourth dimension.

Never take more 1 dose a day.

If y'all oft forget doses, it may aid to set an warning to remind you.

You could also enquire your pharmacist for advice on other ways to help you remember to accept your medicine.

If you're worried, contact your anticoagulant clinic or doc.

What if I have too much?

If yous take an actress dose of warfarin, call your anticoagulant dispensary straight abroad.

You lot may need to change your next dose of warfarin or have a blood examination.

If you take more than than 1 extra dose of warfarin, you're at chance of serious haemorrhage.

Urgent advice: Call your md or anticoagulant clinic, or become to A&E if:

• you take more than than ane extra dose of warfarin

If you lot need to go to infirmary, have the warfarin packet or leaflet inside information technology, plus any remaining medicine, with y'all. If y'all accept a yellow book, take that too.

Find your nearest A&Eastward

5. Bleeding and what to do about it

While warfarin has enormous benefits, the downside is that it can make you drain more than than normal.

This is because while you're taking warfarin, your claret will not clot every bit easily.

You're more likely to get haemorrhage problems in the showtime few weeks of starting warfarin treatment and when you're unwell - for instance, if you have flu, are existence sick (vomiting) or have diarrhoea.

Autonomously from the risk of bleeding, warfarin is a very safe medicine. It's condom to take for a long time, even many years.

Less serious bleeding

It's usual to bleed more easily than normal while you're taking warfarin.

The kind of bleeding you might take includes:

• periods that are heavier and last longer than normal
• bleeding for a little longer than usual if y'all cut yourself
• occasional nosebleeds (that last for less than 10 minutes)
• haemorrhage from your gums when you brush your teeth
• bruises that come up more hands and take longer to fade than usual

This blazon of haemorrhage is not dangerous and should end past itself.

If it happens, go on taking the warfarin, but tell your doctor if the bleeding bothers you or does not stop.

Things you can do to help yourself

• Cuts press on the cut for 10 minutes with a clean material.
• Nosebleeds – detect out how to stop a nosebleed or watch this video on nosebleeds.
• Bleeding gums – if your gums are bleeding, try using a soft toothbrush and waxed dental floss to clean your teeth.
• Bruises – these are harmless, but can exist unsightly. It might aid to make them fade more quickly if you put an water ice pack wrapped in a towel over the bruise for ten minutes at a fourth dimension several times a twenty-four hours.

What you can do to foreclose bleeding

While y'all're taking warfarin, exist careful when yous practice activities that might cause an injury or a cut or bruising.

It can assistance to:

• finish playing contact sports or other activities than can crusade a caput injury, such as football game, rugby, hockey and horse riding
• wear gloves when you use precipitous objects similar pair of scissors, knives and gardening tools
• stop moisture shaving or removing hair with wax - use an electric razor or pilus-removing cream instead
• take false teeth (dentures) or retainers out for a few hours a day, if you wear them, to give your gums a residuum – practise not wear dentures or retainers that do non fit properly
• tell your doctor, dentist or nurse that you accept warfarin ahead of having whatsoever medical or dental procedures or surgery - that includes vaccinations and routine appointments with the dental hygienist

Serious bleeding

Occasionally, you can take serious bleeding from taking warfarin.

This can be dangerous and needs urgent medical attention.

Urgent advice: Stop taking warfarin and telephone call your doc or anticoagulant clinic, or go to A&E, now if:

You take

• red pee or blackness poo
• big bruises or bruises that happen for no reason
• nosebleeds that last longer than 10 minutes
• blood in your vomit or you're cough upward blood
• severe headaches, fits or seizures, changes to your eyesight, numbness or tingling in your arms or legs, or feel very tired, weak or sick – these can exist signs of bleeding in your brain
• whatever bleeding from a cut or injury that will non finish or slow downwardly

These are symptoms of serious haemorrhage.

If you have serious bleeding, stop taking warfarin.

6. Other side effects

Like all medicines, warfarin can cause side effects, although not everyone gets them.

Common side effects

These side effects are ordinarily mild, but talk to your doctor or pharmacist if these symptoms bother you or do not go away:

• a mild rash
• hair loss

Serious side furnishings

Call a doctor straight away if you develop whatsoever of these serious side effects:

• yellowing of your peel and nighttime urine - these can be signs of liver problems
• painful and swollen patches on your skin
• severe headaches, fits or seizures, changes to your eyesight, numbness or tingling in your arms or legs, or feeling very tired, weak or ill – these can be signs of bleeding in your encephalon

Serious allergic reaction

In rare cases, warfarin can crusade a serious allergic reaction (anaphylaxis).

These are non all the side effects of warfarin. For a total list, run across the leaflet inside your medicines packet.

Information:

You lot can study any suspected side outcome using the Yellowish Bill of fare safety scheme.

Visit Yellow Carte for farther information.

7. How to cope with side effects

What to do near:

• a balmy rash – information technology may help to take an antihistamine, which you can buy from a chemist's. Check with the pharmacist to run across what blazon is suitable for you. If the rash does not go away within a few days, speak to your medico.
• hair loss – speak to a pharmacist or your physician if this is bothering you

eight. Advice about food and drinkable

Information technology'due south very of import to keep your diet stable. This means your dose of warfarin is more likely to stay the same.

Any big changes in what you eat or drinkable can modify how your body responds to warfarin.

Speak to your doctor or nurse before irresolute what you eat - for instance, before yous go on a nutrition to lose weight.

Foods containing a lot of vitamin Grand can interfere with how warfarin works.

These include:

• greenish leafy vegetables, including broccoli, spinach and lettuce
• chickpeas
• liver
• egg yolks
• wholegrain cereals
• mature cheese and blueish cheese
• avocado
• olive oil

It'southward important that you eat foods containing vitamin M, so rather than leaving them out of your nutrition, brand sure you lot consume like amounts of them regularly.

This will mean the level of vitamin 1000 in your blood stays adequately constant and makes it more likely that your INR level stays stable.

Exercise not drink cranberry juice, grapefruit juice or pomegranate juice while you're taking warfarin. It can increase the blood-thinning effect of your medicine.

9. Pregnancy and breastfeeding

Warfarin is not usually recommended during pregnancy.

It tin exist harmful to the infant, peculiarly during the starting time 12 weeks of pregnancy.

Warfarin and breastfeeding

Warfarin is generally safe to take while breastfeeding.

Non-urgent advice: Tell your doc if you're:

• trying to go pregnant
• significant
• breastfeeding

ten. Cautions with other medicines

Many medicines and supplements can interfere with warfarin. This tin can make you more than probable to have haemorrhage.

You might demand a blood test to check the other medicine is not affecting how your blood clots.

If y'all're taking warfarin, tell your doctor before starting to take these medicines:

• medicines for heart problems, such as amiodarone, quinidine and propafenone
• non-steroidal anti-inflammatory drugs (NSAIDs) similar ibuprofen and aspirin
• cholesterol-lowering medicines, such as bezafibrate, gemfibrozil, clofibrate and cholestyramine
• antibiotics, such every bit erythromycin, co-trimoxazole or norfloxacin
• vitamin 1000 supplements
• miconazole gel for fungal infections similar thrush

Taking warfarin with everyday painkillers

Information technology's condom to take paracetamol while you're on warfarin.

But take a lower dose of 1 tablet (500mg) at a time. Do non take more iv tablets (4 10 500mg) over a 24-hour period.

Taking more paracetamol than this may make your blood slower at clotting. This puts you at hazard of bleeding.

If you're withal in hurting after taking paracetamol for 3 or 4 days, speak to your chemist or doctor.

Do not take aspirin and ibuprofen while you're taking warfarin unless a doctor has said it'due south OK to. They increase the chance of bleeding.

Mixing warfarin with herbal remedies and supplements

Practice not have St John's wort, the herbal remedy for depression, while yous're taking warfarin.

It tin increase your risk of side effects.

Of import: Medicine safety

Tell your doctor or pharmacist if you're taking whatever other medicines, including herbal medicines, vitamins or supplements.

11. Common questions

How does warfarin piece of work?

Warfarin is a type of medicine known as an anticoagulant. Information technology makes your blood jell more slowly.

Claret clotting is a complicated process involving substances chosen clotting factors.

Clotting factors are made by the liver and assistance finish bleeding. They work with claret cells called platelets that trigger the clotting process to make sure your blood clots properly.

To brand some of the clotting factors, the liver needs a good supply of vitamin K.

Warfarin blocks the liver from using vitamin Thousand to make clotting factors. This thins your blood, so it takes longer to jell.

How long does it have to work?

Warfarin takes almost iii days to build up its blood-thinning upshot.

But it can take weeks or even months before y'all settle on the correct dose.

This is because everyone reacts differently to warfarin, then it'due south usual for the dose to get up and downwards when yous outset start taking it.

You volition not feel any different while y'all take warfarin.

The only fashion to check it'due south working is to accept a blood sample and meet how long your blood takes to clot.

What will happen if I cease taking it?

Do not stop taking warfarin without talking to your doctor.

If you lot stop taking warfarin, the charge per unit at which your claret clots will quickly return to what it was before you lot started taking information technology.

This ways yous may exist at an increased risk of serious issues like strokes, heart attacks, DVT or pulmonary embolism.

Are there any other similar medicines?

Warfarin is one of the oldest and virtually commonly used anticoagulants.

There are newer anticoagulants, such as rivaroxaban, dabigatran, apixaban and edoxaban.

Warfarin does not seem to be any better or worse than newer anticoagulants at treating and preventing claret clots.

Only the newer anticoagulants may be more user-friendly because you practice not need to accept regular claret tests or be quite every bit conscientious about what y'all consume.

Tin I drinkable alcohol with it?

You can drink alcohol while taking warfarin as long as you stick to the national guidelines of no more fourteen units a week for men and women.

A standard glass of wine (175ml) is 2 units. A pint of lager or beer is commonly ii to 3 units of alcohol.

Drinking heavily, especially binge drinking lots of alcohol in one get, is dangerous while taking warfarin.

The booze tin increment warfarin's effect and make you more likely to bleed.

Will I need to end warfarin earlier surgery?

Because of the risk of bleeding, your dose of warfarin may need to be lowered or stopped a few days before you lot have an operation.

Tell the doctor that you're taking warfarin.

Can I take a tattoo or piercing?

It'south not unremarkably recommended to have a body piercing or tattoo while y'all're taking warfarin because of the increased risk of haemorrhage and infection.

If yous all the same want go ahead, talk to your doctor about your specific risks in instance y'all need antibiotics or adjustments to your warfarin dosage.

And let the tattooist or piercer know beforehand that you're taking a claret-thinning medicine.

Will I demand to stop warfarin before dental handling?

Yous can however go to your dentist as usual. But tell your dentist if yous're taking warfarin before you have any handling, especially if yous need to have a tooth out.

You may need to accept blood tests earlier starting treatment to make sure your blood will jell enough to terminate whatever bleeding.

Before taking out a molar, your dentist volition need to know how well your blood is clotting.

This will exist checked using the international normalised ratio (INR) test.

About people do non demand to change their warfarin dose.

Can I accept vaccinations?

Information technology's safe for you to accept vaccinations, just tell the nurse or doctor that yous're taking warfarin.

If the vaccine is normally given by injection into the muscle, provided yous're up-to-date with your blood tests and the results are within the target range, yous can have the injection as normal into muscle.

Or the injection can be given into the layer of fat underneath your skin. This is called a subcutaneous injection.

It might help prevent bruising if you press on the injection site for x minutes later the vaccination.

Volition it affect my contraception?

Warfarin does not impact whatever type of contraception, including the combined pill and emergency contraception.

Merely you should have an INR claret test when you start or stop taking contraception.

This is to check whether your warfarin dose is still at the right level or needs to exist changed.

Will it affect my fertility?

In that location's no business firm bear witness to suggest that taking warfarin volition reduce fertility in either men or women.

But it's non suitable for women who are meaning or trying to go pregnant. This is because information technology may harm the baby.

Will it affect my sex life?

There's no prove that taking warfarin affects your sex life.

Can I take recreational drugs with information technology?

Information technology'due south thought that cannabis can impact your blood tests and increase your take a chance of serious bleeding.

Information technology's not clear how other recreational drugs like cocaine and heroin affect warfarin. They could exist potentially dangerous.

Tell your md if you remember you may take recreational drugs while you lot're on warfarin.

Can I drive or ride a bike?

Warfarin does not affect your concentration, then you tin drive or ride a bike while you're taking it.

Can lifestyle changes aid?

You can reduce your risk of having a blood clot by making changes to your lifestyle, such as:

• not smoking
• eating well
• getting exercise
• keeping to a healthy weight, or losing weight if you need to

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Source: https://www.nhs.uk/medicines/warfarin/

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