About to be prescribed warfarin for the first time, is there an alternative?. I eat a lot of foods with vitamin K.

[PepperT]

This may sound silly but I don't want to have to restrict my diet, it would have to be a really radical change on my part, I eat lots of Watercress, Brocolli, Sprouts etc, basically all the things you are told to eat in small amount or avoid!

[Lure2]

The answer is to eat the same amount every day. Perhaps you can not eat as much as before. I eat lots of colours on my plate and lots of fruits. I eat broccoli evey day.

You must know that the K-vit foods change your INR dramatically if you change the amounts of it!!!! You have to make notes.

I never change (almost never) the number of tablets of warfarinbut but instead eat more broccoli the day my INR is too high.

As I selftest it is more easy for me to notice the INR-Changes. I selftest every second day at present. My range is 3.5.

There are other possibilites than Warfarin. Some people take Fragmin also. Talk to your doctor.

Good luck from Kerstin

[Lexi_Img in reply to Lure2]

I do the same Kerstin.

[Lure2 in reply to Lexi_Img]

Great to hear! You will learn to make it stable and how much broccoli or other vegs you must/can eat?

I wish you happiness in the Disney-World soon together with you family,

Kerstin

[Lexi_Img in reply to Lure2]

Thank you for concern and help. Stay healthy

[PepperT]

Thanks for that Kerstin

I have an appointment with my Rheumatologist this afternoon and wanted to be prepared. I have quite a restricted diet already for other reasons and it will be hard getting it right.

[Manofmendip]

Hi

As Kerstin has said you should be consistent in what you eat, in terms if Vit K rich foods, then you should more easily be able to balance your Warfarin dose to give you the required INR level. Vit K reduces the effect of Warfarin, so lowering your INR. Excessive alcohol can increase the effectiveness of Warfarin and can increase INR.

Like Kerstin I used to self test when I was on Warfarin but I am now on Fragmin.

Good luck and let us know how you get on.

Dave

[MaryF Administrator]

Best of luck I have no further comments to add to the good advice you have received already. MaryF

[Salty]

Hi Pepper. I agree with Lure. You do not need to avoid the foods high in vitamin K, but it is very important to keep the amount of these foods roughly constant in your diet. Even so, for some people with Hughes syndrome it can still be very difficult to regulate your INR. Mine was very labile and to me this felt very unsafe. There are other options. One is heparin which is more expensive than warfarin and is given by injection. For some, it is more effective than warfarin. Eg for me, it was much more effective at treating the severe headaches and memory loss than high dose warfarin. The other options are the newer oral anticoagulants, eg rivaroxaban, apixiban and dabigatran. There is an ongoing trial of rivaroxaban in APS currently in London, but the data have not yet been released. So this option would be experimental, but there are several APS patients using these agents and from what I have read, most (but not all) seem to do well on them. Indeed, rivaroxaban and apixaban are just oral versions of heparin, ie they affect the clotting cascade in the same way.

[PepperT]

Many thanks Salty, if it comes to the crunch I may ask about rivaroxoban and if it's available, however our health authority is notoriously stingy so I'm not holding out much hope on that front!

[Mom3mmc]

Hi Pepper, as others have said the key is being consistent with the amount of vitamin k foods you eat. I eat the same exact salad with dark leafy greens, peppers and other yummy veggies every single day and my INR is very stable. Good luck, Jen

[ratbert]

I would suggest the first thing you should do is *not* borrow trouble! If you are fortunate you may find that you can continue to eat what you always have without any impact on your INR.

Some warfarin users are very sensitive to any change in diet, activity, sleeping patterns and goodness knows what else. For others, INR may be stable for long periods regardless of those things. Obviously, if you turn out to be one of the former then you'll need to be more attentive to consistency - and as others have said, it's consistency that is key.

For me, broad consistency seems to be sufficient to generally maintain a stable INR. A significant change in exercise patterns seems to affect my INR more than what I eat, although shifting from summer to winter diet (salads vs vegetables) does seem to have some impact. The biggest impact I'm aware of is actually illness - any sort of cough, cold or whatever seems to throw my INR completely off.

So, don't worry too much about what might be, and just find out what works for you. It may turn out that warfarin isn't for you, but there's no reason to assume it isn't before you even try it.

p

[Lure2 in reply to ratbert]

Well said!

Have a nice summer. Kerstin in Stockholm

[Lexi_Img]

Your blood will get very sticky and thick. Can you be consistent

With small amounts? You should speak to your doctor. I for one must pay attention to my diet. Good luck

[Lexi_Img]

I am a consistent diet. I became very ill and was hospitalized on Steroids. This drug also made my INR off the chart they could not get a read.. I do not want to know what could of happened if my diet wasn't consistent. I am glad I can tell you about today. Sometimes we just do what we have to do. I am also a Vegan and respect the diet.

Take care xxx

[Lexi_Img]

May

[GinaD]

One advantage warfarin has over the newer oral decoagulents: warfarin has been used for decades and it presents no side effect surprises. As one doctor told me years ago,"it does what we want it to do, and that's it!".

[THEUNIQUELDY in reply to GinaD]

Sure warfarin has been around forever but it doesn't work correctly on everybody and it does have a higher risk of a bleed than the newer ones then there is the diet restrictions & the blood draws.

[Holley]

I was always told that they'd adjust my dose around my diet. The main point was to keep my diet consistent.

[Lure2 in reply to Holley]

It should be that way.

Kerstin

[THEUNIQUELDY]

I never in 4o+ years have had good results on warfarin & even had a bleed once but that is just me. I am a hard stick so the blood draws were a big draw back too. Now I 'm on Xarelto 20 mg. daily and love it. No diet restrictions and no blood draws ever. My very best to you. Only thing, without insurance it is pricey.

[Lure2 in reply to THEUNIQUELDY]

You must have been lucky that you have not had a clot or stroke as you have never had good results on Warfarin during 40 years.!

My youngest daughter could never take Warfarin because she is so difficult to stick in her arm.

Good luck with your new drug! Kerstin in Stockholm

[Sal0712]

Hi Pepper. I was reluctant to change my diet when going on warfarin as I also love my fruit and veg. I did however have to make a few tweaks, but nothing too drastic. As the others have said, it's all about keeping things consistent within your diet. Don't overload on greens at the weekend, and then have nothing else all week. You need to eat them every day or every other day. Also try to keep your meals consistent. Trying to eat around the same time every day, and eating little and often helps. I was also told that you need to make sure your having foods containing fibre and carbs when on warfarin, as it helps with the way the medication absorbs into your system. It takes a bit of trial and error at first, but you will soon learn the signs that your levels are out eg, today I have a burning sensation in my foot which I get when my INR is low, I know tonight to stay away from greens altogether! Give yourself time to adjust, and try not to get stressed, as your mental health can have an effect on how your medication works too!! Hope you find what works best for you soon. Stay in touch and let us know how your getting on. Sally :o)

[Lure2 in reply to Sal0712]

I totally agree to that Sally,

Kerstin

[tim47]

On warfarin over 40 years, try and keep diet similar but don't fret about it. Self test ever other day so can soon sort any big deviations out. Have no intention of taking any of the newer drugs .

[pinkangel16]

I was on warfarin following a pe. I was due to go on holiday after 6 months and was basically fed up with the restrictions of warfarin. My consultant changed me to Rivaroxaban and I haven't looked back.

Still not sure yet if I'll need to be on life long, but if I am it wouldn't be so bad on Rivaroxaban but on warfarin I'd be well unhappy.

I'm healthy (ish obviously) 48 yr old female live in the uk - was told it's a newer drug but she didn't have any concerns about it.

[Lure2 in reply to pinkangel16]

Do you have APS (Hughes syndrome)?

Best wishes from Kerstin in Stockholm

[pinkangel16 in reply to Lure2]

Hiya, not sure yet. Have had several visits to the consultant and lots of tests but they haven't done that yet. Depends on what happens with some other tests, when I see her in a few weeks she will advise of the next step - this is a long old process! Been 9 months since the pe with no idea yet of the cause :-(.

But Rivaroxaban isn't causing any problems or interference eith live in general which is good.

[Lure2 in reply to pinkangel16]

Good luck with your appointment!.

If you have APS welcome back to us for more info.

Best wishes from Kerstin in Stockholm

[chrissybell in reply to Lure2]

Hiya, I am a 49 year old who at age 47 had mutiple PE's 18 months ago (and pleurisy), with no cause. I work for a GP practice and my GPs kept pestering me to get further tests to find cause. Last week I was tested positive for lupus anticoag (2 positive tests over 3 months) and was very unstable on warfarin (vegetarian) so am on Dabigatran. It's great and no blood testing. Like pinkangel 16 I have no interference and can eat what I like - instead of thinning the blood it tells the receptors in the brain (Hm debatable I know - my kids would say) NOT to clot the blood. It is an expensive drug, but if patients are not stable on warfarin it's an option (It's not yet licenced for anything but Atrial Fibrilation yet, but at GP discretion can be used).