Health

  What is oral anticoagulation?

Oral anticoagulation is a drug that helps to prevent the clotting (coagulation) of blood and to maintain blood flow.

  What are blood clots?

When you are preparing your family dinner, preparing that delicious salad, or when your husband is changing his car tire and accidentally cuts his finger, immediately the cut starts bleeding. However, due to a particular blood property the bleeding stops because blood clots start to form. The formation of blood clots prevents hemorrhages.

  Are blood clots bad?

Under normal daily conditions, blood clots are extremely useful to health’s maintenance, as seen before. The problem occurs when there is clot formation during unwanted situations, obstructing a blood vessel (in the brain, liver and legs), or when there is clot formation within a heart prosthesis and valves, damaging blood circulation what can lead to death.

  Is that when the blood clots are harmful?

Yes, under those circumstances, when formation of blood clots can mean risk of death, the oral anticoagulation therapy is indicated.

  What medicaments should I take to avoid these problems?

Warfarin is the most indicated oral anticoagulant to prevent formation of blood clots.

  How should I take Warfarin?

The dose of Warfarin should always be evaluated and prescribed by a doctor who in your case will prescribe the most indicated dose to anticoagulate your blood.

  If my blood has insufficient coagulation capacity, how can I avoid hemorrhage?

Have your blood drawn and sent to a lab to run a TP/INR test regularly. These dosages are necessary for the ideal Warfarin dosing adjustment. You must also prevent to hurt yourself, wearing gloves when manipulating sharp-edged or sharp-pointed objects, and avoid any radical impact sports.

  With what frequency should I take a PT/INR test?

The TP/INR test should be performed upon your doctor request. Usually this test should be performed before your periodic visit to a doctor, so you will have your test results available when seeing your doctor. This test also needs to be performed urgently if there is suspicion your medicine dosage is wrong, mainly when there is gum bleeding and presence of blood in urine.

  Where and how should I take a PT/INR test?

The TP/INR test should be performed the same way as other blood tests. In urgent tests there is no need of previous fasting. We always recommend performing the TP/INR test at the same laboratory to avoid small variations of the results. You should take medical advice about your lab choice.

  When is the best hour to take my oral anticoagulant?

We always recommend taking an oral anticoagulant at about the same time, preferably at 05:00 pm.

  Is there a standard oral anticoagulant dose?

There is not a pre-established dose. Each patient will take his/her own daily dose according to the oral anticoagulant action in their bodies that is analyzed performing a TP/INR test.

  I forgot to take my daily dose. What do I do?

If you remember in the same day, take your oral anticoagulant dose immediately. If you only remember on the following day, don’t double-up your dose to compensate your negligence of the previous day.

  During some days I didn’t take my oral anticoagulant. What do I do to start taking it again?

First of all, perform a new TP/INR test to know the actual value. Then your oral anticoagulant dose will be established and after that new TP/INR tests will have to be performed to readjust your dose.

  Can I take MAREVAN together with other medicines?

There are some medicines that decrease and others that potentialize warfarin's anticoagulation effect. You should inform your doctor about all medicines you are taking to know what medicines are contraindicated in your case. It is good practice to always follow your doctor advice if a new drug is recommended for you, so he will check if this new drug can modify warfarin's anticoagulation effect since hemorrhage can occur. Besides, you should keep in mind that the practice of self medication has a high potential medication interaction with the oral anticoagulant. One example is the common analgesics that contain acetilsalicilic acid and can potentialize warfarin's anticoagulation effect leading to hemorrhage. It is advisable to take Dipyrone in case of headache or fever. Never forget to say you are taking oral anticoagulants with Warfarin when seeing a doctor, especially if new medicines are prescribed.

  Do I have to go on an especial diet while taking oral anticoagulants?

The oral anticoagulant therapy with Warfarin reduces the coagulation factor activity that depends on vitamin K; so, you should take care when consuming vitamin K rich foods. They are not forbidden, but you should get the same amount of vitamin K each day, so there wouldn’t be any variations from one day to another. In other words, if you can avoid ingestion of vitamin K rich foods, such as cabbage, green tea, turnip, spinach, broccoli, lettuce, liver and craw, you will be reducing food action in the oral anticoagulation therapy.

  Can I drink alcoholic beverages while taking oral anticoagulants?

You are not forbidden to drink alcoholic beverages; however, you should not drink too much alcohol. If your organism ingests too much alcohol, the effect will be like drinking an extra oral anticoagulant dose, so, if you perform a TP/INR test after 2-3 days after too much alcohol, probably the INR value will be over the recommended upper range limit; this occurs because the alcohol potentializes the action of the oral anticoagulant with Warfarin. Patients taking oral anticoagulants should not drink more than two cups of beer or one shot of whisky.

  Will there be any unwanted effects in my body while taking oral anticoagulants?

The oral anticoagulant adverse effects are not common and include skin redness, nausea, abdominal pain, headache, diarrhea, and hair loss. In relation to the hemorrhagic effects, it would be useful to see if there is any gum bleeding, nose bleeding, purple spots, and blood in urine. Any adverse effect must be immediately communicated to your doctor.

  When a surgery or tooth extraction is needed, what do I do?

Whenever you need to undergo any surgical procedure or tooth extraction, your doctor should previously be informed and prepare you for these procedures. It is important to inform your dentist that you are taking an oral anticoagulant, because the decision to interrupt your treatment when undergoing a tooth extraction should be taken by your doctor together with your dentist.

  If I’m pregnant can I still take oral anticoagulants?

After confirming your pregnancy your oral anticoagulation therapy should be immediately interrupted due to the high risk of abnormal fetal development.

  Will I be able to breast feed while taking oral anticoagulants?

Breast feeding is not expressively forbidden when taking oral anticoagulants; however, this decision should be taken and attended by specialist doctors and doctors with great anticoagulation knowledge.

  What should I do if I notice any kind of spontaneous hemorrhage?

Inform your doctor immediately. Probably the anticoagulation level is over the recommended level and the anticoagulant dosage should temporally be interrupted or reduced; however, only your doctor should decide the medicine temporary reduction or interruption.