Warfarin.

I have now been prescribed Warfarin instead of Aspirin. Does everyone needs weekly blood tests while taking this ? It sounds complicated about vitamin K . If I eat more green veg one week and a lot less next week , I have to have blood tests. I have heard there are a lot of side affects with Warfarin. Can anyone tell me what they are like on this please ?

[BobD Volunteer]

I have been on it 11 years or more with Zero problems apart from slightly brittle nails. .Try to maintain a regular diet but don't avoid things. Make you warfarin dose fit your life style not the other way round. The amount you take is unimportant, only your INR. Once you are setttled on it you shouldn't need testing too often, mine are about every six weeks on average unless I do something silly and miss a dose and slide out of range.

Of course we are all different and whilst the great majority of people do well on warfarin some never find a balance easy and for those thankfully we now have NOACs .

Good luck and don;' worry.

Bob

[Hidden in reply to BobD]

Don't worry once it has settled you don't need as many tests. Ours do it by a prick to the finger and test it there and then so you get an instant result. They use to take blood and you could be waiting over an hour for results and dosage instructions. When I went last week they were trying to get me to sign up for a home testing kit but I didn't think the expense made it worth while.

I was on one of the newer drugs which didn't need any tests but have gone back to warfarin as I don't get any side effects with it.

As for the food I don't worry about it my INR only fluctuates slightly and it usually stays within the target range.

Once you are in the routines you'll find it all fine.

[Hidden in reply to Hidden]

Thanks Richard.

[Hidden in reply to BobD]

Thank you Bob

[Hidden]

I am just reading about Warfarin . One thing it says is hair loss, I really don't think I could cope with that. I will just have to wait and see.

[barbara2 in reply to Hidden]

When I asked my doc about hair loss he said he was not aware of that being a side effect, so he had me visit with the pharmacist who said it is not common, but could happen. He also said that the larger the dose, the more of an issue it would be, if it was an issue in the first place.

After stopping warfarin, you would get the "lost" hair back. I believe my hair has thinned out. I use a volumizer in my hair, which helps some.

[Barb1 in reply to Hidden]

Why don't you ask about one of the new anti coagulants that aren't as complicated to take?

[Hidden in reply to Barb1]

I cant take them Barb as I have Coeliac. They said I might not absorb them. I wish I could take them.

[Barb1 in reply to Hidden]

A while ago someone on this site said that they were coeliac and on Apixaban as no diet restrictions to consider alongside the ones for coeliac disease. They had no.problems.

[Hidden in reply to Barb1]

I will ask about this Barb . Thanks.

[rebecca70]

I have been using warfarin for about three years and have no problems tho my inr will vary from time to time with no obvious reason.It is checked once a month if it is in range. if not then it gets checked the following week.

I eat the same amount of romaine lettuce and it is in the same bowl so the amount is pretty consistant.

Best wishes for a worry free holiday.

Rebecca

[Hidden]

Jacksnanna,

When I first went on Warfarin I was tested weekly until I stabilised, then it became fortnightly, and then once the INR nurse saw that it was still stable I tested four weekly.

Your INR readings will 'chuck a wobbly' once in a while, as mine have done recently when for no accountable reason the INR dropped to 1.9. INR nurse rearranged existing doses and lo and behold I went back up to my target value of 2.5 within a week. Apart from that I am normally around 6 to 8 weeks with my INR tests.

For me I have had few side effects, no hair loss but I have the same as BobD, brittle nails.

I self test at home and take my device with me when I travel to Australia. I am sensible with my food and minimise my intake of greens. I have never stopped greens at all but the ones that are loaded with vitamin K I eat seldom but do eat them. I regularly eat brussels sprouts and broccoli. Like many things in life its all about finding a balance.

Do suggest you get online and 'Google' food and Warfarin, then you will get a wide ranging view on do's and don'ts. There are many other products that can destabilise your INR. Grapefruit and Cranberry products can be an issue.

In the 7 years I have been on Warfarin I have twice had to come off it, once for a CT scan and had no bridging anticoagulant and once when I had a partial knee replacement. On this occasion I was given a bridging anticoagulant, Fragmin, so that I was still anticoagulated. On both occasions from the day I stopped Warfarin until I got back in range was exactly 29 days.

Hope that helps.

John

[MarkS]

I would recommend you get a Coaguchek if you're going to be on warfarin long term. This enables you to monitor your own INR at home in a couple of minutes. I check mine once a week. You do need to buy it - it's £299 but the test strips should be free from your GP.

[Hidden in reply to MarkS]

I will look into it Mark. Thanks

[NooNoo14]

In the UK we normally have weekly tests until your recommended INR is reached, then they move from 4 to 6 to 8 weeks.

Like the others the only side effect has been brittle nails and my hair is slightly thinner but no noticeable difference.

With regards to food, I avoid grapefruit but don't worry about leafy vegetables. I eat them every day and my INR remains stable. I think it's more of a problem if you eat platefuls every now and again.

I take mine with my meal at around 7pm.

Try not to worry about it, it is after all stopping you have a stroke - got to be good.

Merry Christmas.

Netty

[Hidden in reply to NooNoo14]

Thank you all for being so helpful. I feel so much better . You are all wonderful . So pleased found this site . Happy Christmas all.

[annlynne]

rfarin with a stable INR, but I had deferred taking it for years despite medical advice. so, talk to the clinician, I have had no side effects after being on Warfarin for 8 years. Once your INR is stable your blood tests are less frequent . Best to you for Christmas , keep well.

[ILowe]

I have been on Warfarin for 23 years, self testing, and self dosing. From the beginning I was self-dosing. It really is easy, especially once you get past the first year. As for food, I eat what I like when I like. I have an irregular lifestyle, never mind. For instance, I will splurge sometimes on one delicious bowl of sprouts: it is two splurges that swings the INR. The keys are:

1. Tolerate a wide range, without changing the dosage. The body naturally rights itself, given time without changing the dose. Premature correcting leads to the dreaded swings. It takes 2-3 tests out of range over at least two weeks intervals to make the case for a dose change, meanwhile, you have the courage to stay put without a change of dose. The medical profession often thinks the range is only one INR unit eg 2.0 to 3.0 and that a dose change is needed when you go over the lines. My records show the natural range can be as high as 2.5 units. This is the natural background variation and we should respect it.. So, my range is 2.5 to 5.0 with a preference for 3.0-4.0 (the starting point is 2.5 because of a mechanical valve). With that I have easy dosing.

2. If you do make a change, make it a tiny change of 5-10%. The best reference I can find for this is Kim et al. Effect of a simple two-step warfarin dosing algorithm on anticoagulant control as measured by time in therapeutic range: a pilot study. Journal of Thrombosis and Haemostasis vol 8 p101-106. It really is an easy read. I can supply other references.

3. Too low is worse than too high. If in doubt, I err on the side of allowing a higher INR.

[PeterWh]

The norm nowadays is either not to restrict diet or to only minimally restrict by not eating one of the few things tat have a high effect on INR. I was told it is less than 0.5% who have to restrict green things (and I'm one of those awkward ones).

I'm on weekly testing because my INR fluctuates a lot (initially by up to 2.3 from one week to the next but now by up to 1.0. Because of multiple conditions and to ensure I am always anticoagulated my range is set at 2.5 to 3.5 with weekly testing.