Preventing Your Body From Forming Clots It Does Not Need
Anticoagulation Therapy Warfarin and Prothrombin (Protime /INR) Testing

The INR
You will be tested regularly (at least monthly) while you are taking warfarin. The test is an International Normalization Ratio or INR. At first, the INRs will be done at least weekly until we find the proper dose for you. Regular INRs are critical in the effective use of warfarin. We will assign a range for the INR based on your cardiac condition, personal history and anticoagulation goal. Your medication will be adjusted accordingly and you will be given your next blood test date.It is critical that you follow these instructions closely for safe and effective anticoagulation. You will be contacted after each blood test. If you are not contacted within 24 hours of your test, take your warfarin as previously directed and contact our office the next business day for instructions.If circumstances prevent you from getting your INR on the recommended date (weather, vacation, conflicting appointments, etc.) get your INR checked the next possible date. If this is greater than one week from your appointed day please call us for instructions. We will work with you whenever possible so the anticoagulation therapy does not rule your life!

Factors that Affect Warfarin
Many outside influences alter the effectiveness of warfarin. Once you start your anticoagulation therapy you must contact us any time you start, stop or change dose of any other medication. We will need to recheck your INR to see if adjustments are necessary. Vitamin K (usually found in green, leafy vegetables) can also change the dose requirements of warfarin. If your diet changes radically, please let us know as soon as possible. Alcohol can also affect the dose requirement; binge drinking should be avoided at all times. If you miss your dose or accidentally take more than prescribed, contact our office for instructions. Do not try to catch up or hold your dose on your own.

What to Look Out For
Rarely, warfarin can cause a rash. If a rash develops within one to two weeks of initiating therapy, call us. Some bruising is normal with warfarin, but a bruise that continues to spread over 24 hours needs attention. Call us for instructions. Bleeding from the mouth or nose, blood in your urine or stool (blood in the stool can be red or black) or unusual pain or swelling should be brought to our attention immediately. Do not ever stop your warfarin or alter your dose without contacting us. This can lead to bigger problems than the one you are experiencing. Please bring any other concerns to our attention, we are here to help you any way we can.

Remember
· Take your medication and have your INR checked as recommended
· Contact us with any medications changes, prescribed or over the counter
· Consistency in diet and daily activity helps maintain your prescribed level
· Contact our Anticoagulation Clinic with any questions or concerns you may have. We re here to help.
· Do not, ever, alter your dose without consulting our clinic.

Dedicated to Columbus
The “goal standard” in dealing with heart disease is to practice healthy habits and to faithfully follow the treatment regimen established by your doctor. The Columbus Cardiology Associates, P.C. are dedicated to providing are residents with world-class heart caring right in our community. Providing a state-of-the-art anticoagulation therapy is just one example of our dedication to you.........continue to next page.