Pulmonary - Critical Care Associates
of East Texas

Jeffrey M. Shea, M.D., F.C.C.P.
                              Catherine M. Martinez, M.D.

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Coumadin Therapy

THINGS YOU SHOULD KNOW ABOUT TAKING COUMADIN

In some disease states, clotting occurs when it shouldn’t. If you have been diagnosed with a Pulmonary Embolism (blood clot to the lung), Deep Vein Thrombosis (blood clot in the legs), certain cardiac disorders (artificial valves or arrhythmia’s) or clotting disorders, your physician may prescribe a regimen of Coumadin as therapy.

Coumadin (warfarin) acts by preventing your blood from clotting predisposing those taking it to bleed. It interacts with many other drugs and has several side effects. Coumadin should be used when its benefits outweigh its risk of side effects.

If you are placed on Coumadin therapy, the dosage must be carefully checked to make sure that you are within a therapeutic range. Some patients may need to have their blood checked twice a week to start with and then the frequency reduced to have it checked once a week or every other week.

Another important reason to monitor the Coumadin dose closely is that Coumadin works on the liver by impairing the utilization of vitamin K, thereby inhibiting the manufacture of certain clotting factors. This effect is altered by many things in the diet and also by medications.

Although many drugs may interact with coumadin, these are the most common ones:

  • sulfa
  • flagyl

If you have questions regarding any other medications you are taking, consult your physician.

To keep bleeding time stable, make sure to: 1) take coumadin at the same time every day and 2) keep vitamin K intake consistent from day to day.  A blood test called a Protime is obtained on a regular basis to assure adequate thinning of the blood.

To help maintain a consistent vitamin K intake, follow these guidelines and refer to the food table below:

      • Limit foods considered "very high" in vitamin K to no more than one serving daily;
      • Limit foods considered to be "high" in vitamin K to no more than two servings daily;
      • Foods moderate in vitamin K are not limited, but intake should be consistent on a daily basis;
      • Consume foods low in vitamin K as desired; and
      • Report any significant changes in diet to your physician

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COMMON FOOD SOURCES OF VITAMIN K

 

Food/Serving Size CATEGORY - VERY HIGH Vitamin K content
Kale, 1 c raw Turnip Greens 1 c raw
Swiss chard, raw leaf, 1 c Broccoli, ½ c cooked
Collard greens, ½ c, cooked Spinach, 1 c raw
Spinach, ½ c, cooked Cabbage, green, 1 c raw
Brussel sprouts, ½ c Watercress, ½ c raw
Scallions, ½ c raw Broccoli, ½ c raw

 

Food/Serving Size CATEGORY - MODERATE Vitamin K content

Lettuce, 1 c raw Soybean oil, 1 Tbs.
Cabbage, ½ c, cooked Canola oil, 1 Tbs.
Green apple, 1 medium Cucumber slices, ½ c raw
Coleslaw, ½ c Liver, beef, 3 ½ oz.
Asparagus, 5 spears Ensure, 1 can (1 C)
Cabbage, red,1 c raw  

 

Food/Serving Size CATEGORY - LOW Vitamin K content

Tomato, red, 1 medium Olive oil, 1 Tbs.
Cauliflower, 1 c raw Most cheeses, 2-3 oz.
Carrot, 1 raw Milk, 1 c

 

NOTE: Coffee and brewed black tea are insignificant sources of Vitamin K.

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