Taking Heparin and Warfarin for Deep Vein Thrombosis (DVT)
Heparin and warfarin (Coumadin) are two types of blood thinners (anticoagulants) commonly used in deep vein thrombosis treatment. Though they're called blood thinners, these DVT treatments do not actually thin your blood. If you have DVT treatment, it can keep existing blood clots from getting larger or prevent new ones from forming. They do this by preventing the production of certain proteins needed for blood to clot.
Heparin and Warfarin: The Basics
If you're taking heparin and warfarin for DVT, be sure you:
Tell your doctor about all other medications you take -- including over-the-counter drugs, herbal remedies, and vitamins or other supplements. Some medications can weaken or strengthen the effects of heparin and warfarin, which can be extremely dangerous.
Do not take aspirin with blood thinners unless your doctor says it's OK.
Tell all your doctors and dentists that you're taking heparin and warfarin.
Tell your doctor if you're trying to become pregnant or have become pregnant as warfarin can cause birth defects.
Tell your doctor if you have an accident of any kind. Anticoagulants increase your risk of bleeding.
Let your close family members know how you take your blood thinners.
Carry an emergency medical ID card that contains the name of the medication you're taking; your name, phone number, and address; and the name, phone number, and address of your doctor.
Tips for Taking Heparin and Warfarin for DVT
If you're taking heparin or warfarin for DVT, you should know the following:
Heparin: Traditionally, people have received heparin intravenously (by IV into a vein) in the hospital for about five to seven days. However, low-molecular-weight heparin is effective within hours, reducing complications and hospitalizations. You can give yourself the injections at home, once or twice daily, on an outpatient basis. And because low-molecular-weight heparin is more consistent and predictable, it doesn't require regular blood tests.
Warfarin: You take warfarin by pill once a day, beginning while you're still on heparin. Treatment may continue for about three to six months. While on warfarin, you need regular blood tests to ensure you have the correct dosage.
Ask your doctor how long you will need to take heparin and warfarin. And follow these six tips for taking these anticoagulants:
Take heparin and warfarin exactly as your doctor tells you to.
Take your medication at the same time each day. Your doctor may recommend taking it in the evening so it's easier to make any adjustments in your dosage.
Always double-check your pills when you get a new prescription. Tablets are color-coded. They also have the milligram strength printed on them. If the dose differs from your last one, check with your doctor or pharmacist to make sure it is correct.
Do NOT follow label directions for warfarin. Your dosage is adjusted depending upon your blood results.
Call for refills of your heparin and warfarin prescriptions before you run out. It is risky to go even one day without your medication.
If you do miss a dose, call your doctor or clinic for instructions. Don't try to make up for missed doses or change your dose on your own for any reason.
Monitoring Your Blood While on Warfarin for DVT
Taking warfarin for DVT is a balancing act. Warfarin decreases blood clotting. You want to receive enough warfarin to decrease your risk for blood clots, but not so much that clotting stops completely. If this happens, you're at high risk for bleeding problems. This is why the doctor needs to monitor your blood while you're on this medication.
The test used most often to monitor the effect of warfarin is called prothrombin time (PT). The results of this test determine how high or low your dose of warfarin should be. Your dose may be higher when you first begin treatment, then it may be adjusted to a maintenance level. The doctor may also adjust your warfarin dose in response to your circumstances, such as being scheduled for surgery or needing to take other medications.
Let your doctor know if you're planning to travel. You may need to make arrangements for blood tests right before you leave and while you're away.
Taking Precautions While on Heparin and Warfarin
To prevent bleeding problems, take these precautions while you're on heparin and warfarin:
Use a soft toothbrush.
Floss with waxed floss, instead of unwaxed floss.
Instead of a straight or blade razor, use an electric razor.
Wear gloves while gardening or doing other household projects.
Avoid rough sports, but wear protective gear for activities such as bicycling.
Foods that are rich in vitamin K can make warfarin less effective. Try to avoid large amounts of these foods, but do not suddenly lower your intake without discussing this with your doctor.
Beef or pork liver
Lettuce, spinach, kale, or turnip greens
Canola and soybean oil
Also, talk with your doctor before taking vitamin E or changing your dose. Vitamin E may increase the impact of warfarin. Avoid alcohol or drink only limited amounts. It can also impact how your body handles warfarin.
Potential Side Effects of Heparin and Warfarin
If you're taking heparin or warfarin for DVT, call your doctor right away if you have any of the following signs or symptoms. Many are signs of excessive bleeding.
Red or dark brown urine
Red, dark brown, or black stool
Periods that are heavier than usual
Cuts that don't stop bleeding
Severe headache or stomach pain or upset
Weakness, faintness, or dizziness
Frequent bruises or blood blisters
Skin rash or irritation
Joint or back pain
Swelling or pain at an injection site