Coumadin
For Consumers

The Role of Vitamin K and COUMADIN® (Warfarin Sodium Tablets, USP) Use

Herbal Products and COUMADIN® Use

COUMADIN (Warfarin Sodium) is an anticoagulant medicine. It is used to lower the chance of blood clots forming in your body. Blood clots can cause a stroke, heart attack, or other serious conditions such as blood clots in the legs or lungs. Caution should be exercised when herbal products are taken together with COUMADIN. The use of herbal products may increase or decrease the effects of COUMADIN. It is good practice to have your PT/INR checked when starting or stopping herbal products.
Always talk to your doctor, pharmacist, or nurse before taking any herbal products.

Other Dietary Considerations

  • Avoid drinking cranberry juice or eating cranberry products
  • Avoid drinking alcohol
Important Safety Information
  
Back to top

Vitamin K

COUMADIN (Warfarin Sodium Tablets, USP) is an anticoagulant medicine. It is used to lower the chance of blood clots forming in your body. Blood clots can cause a stroke, heart attack, or other serious conditions such as blocking blood flow in the legs or lungs.

Your liver makes clotting factors that help the blood clot and prevent bleeding. Some blood clots can cause serious medical problems. COUMADIN blocks the formation of clotting factors in the liver that are dependent on Vitamin K.

Vitamin K can interfere with the blood-thinning effects of COUMADIN, so it is very important to maintain a consistent amount of Vitamin K in your diet. Avoid drastic changes in your dietary habits. For instance, eating large amounts of green leafy vegetables, when you normally do not, can increase the amount of Vitamin K in your system.

Notify your healthcare provider before making any major changes to your diet.

Different foods contain different amounts of Vitamin K. But how do you know how much Vitamin K you’re getting in your daily diet?

The US Food and Drug Administration recommends a daily intake of 80 micrograms of Vitamin K, based on a 2000-calorie diet. This is called the Daily Value (DV).

The total amount of Vitamin K you have from day to day may be higher or lower than the recommended 80 micrograms. Because Vitamin K can interfere with the blood-thinning effects of COUMADIN (Warfarin Sodium Tablets, USP), it is important to maintain a consistent amount of Vitamin K in your diet.

Start by telling your healthcare provider about the foods you eat regularly, especially those that are high in Vitamin K. You should also let him or her know about any major changes in your diet. If these changes cause your Vitamin K intake to go up or down, your healthcare provider may want to change your dose of COUMADIN.

The table below can help you monitor the amount of Vitamin K in your diet.
It lists common foods and beverages, portion size, and the amount of Vitamin K per portion. This is a partial list of common foods and their Vitamin K content. Note that the amount of Vitamin K may vary, depending on how the food is packaged and prepared, portion size, and other factors.

Important Safety Information
  
Back to top
Foods Portion* Vitamin K Content
(micrograms)†
BEVERAGES
Coffee brewed from grounds, prepared with tap water 6 oz 0.2
Cola with caffeine 12 oz 0.0
Fruit punch drink with added nutrients canned 8 oz 0.0
Milk 1 cup 0.5
Tea brewed‡ 6 oz 0.0
Water, tap 8 oz 0.0
Important Safety Information
  
Back to top
Foods Portion* Vitamin K Content
(micrograms)†
DAIRY PRODUCTS/EGGS
Butter 1 tbsp 1.0
Cheddar cheese 1 oz 0.8
Eggs, cooked 1 large 2.6
Sour cream, cultured 1 tbsp 0.1
Yogurt plain, whole milk 8 oz 0.5
Ice cream, vanilla 1/2 cup 0.2
Important Safety Information
  
Back to top
Foods Portion* Vitamin K Content
(micrograms)†
GRAIN PRODUCTS
Bagel, plain 1 (4") 1.0
Bread, assorted types 1 slice 0.8
Cereal 1/2 cup 2.1
Flour, white, wheat, all-purpose, enriched, bleached 1 cup 0.4
Oatmeal 1 cup 7.5
Rice, white 1 cup 0.0
Spaghetti, cooked, enriched 1 cup 0.0
Important Safety Information
  
Back to top
Foods Portion* Vitamin K Content
(micrograms)†
FRUITS
Apple 1 3.0
Banana 1 0.6
Blueberries, raw 1 cup 28.0
Cantaloupe 1/8 melon 1.7
Grapes, red or green 10 grapes 7.3
Grapefruit 1/2 grapefruit 0.0
Lemon 1 0.0
Orange 1 0.0
Peach 1 2.5
Important Safety Information
  
Back to top
Foods Portion* Vitamin K Content
(micrograms)†
MEAT
Beef 3 oz 1.9
Chicken 1 cup 4.3
Ham 2 slices 0.0
Salmon 3 oz 0.3
Pork 3 oz 0.0
Shrimp 3 oz 0.0
Tuna, light, canned in oil 3 oz 37.4
Tuna, light, canned in water 3 oz 0.2
Turkey meat only, roasted 1 cup 5.2
Important Safety Information
  
Back to top
Foods Portion* Vitamin K Content
(micrograms)†
FATS AND DRESSINGS
Margarine 1 tbsp 14.5
Mayonnaise 1 tbsp 5.8
Oils
Soybean 1 tbsp 3.4
Olive 1 tbsp 8.1
Corn 1 tbsp 0.3
Peanut 1 tbsp 0.1
Safflower 1 tbsp 1.0
Sesame 1 tbsp 1.8
Sunflower 1 tbsp 0.7
Important Safety Information
  
Back to top
Foods Portion* Vitamin K Content
(micrograms)†
VEGETABLES
Asparagus, frozen, cooked 1 cup 144.0
Avocado 1 oz 6.0
Beans, green 1 cup 20.0
Broccoli, cooked 1 cup 220.1
Brussels sprouts, cooked 1 cup 218.9
Cabbage, raw 1 cup 53.2
Carrots 1 cup 21.4
Cauliflower, boiled 1 cup 17.1
Celery 1 cup 56.7
Collard greens 1 cup 1059.4
Corn 1 cup 0.5
Cucumber, peel removed 1 cup 8.6
Eggplant, cooked 1 cup 2.9
Endive, raw 1 cup 115.5
Kale, cooked 1 cup 1146.6
Lettuce, romaine or green leaf, raw 1 cup 97.2
Lettuce, iceberg, raw 1 cup 13.3
Mushrooms 1 cup 0.2
Mustard greens, cooked 1 cup 419.3
Parsley 10 sprigs 164.0
Peas, cooked 1 cup 48.3
Pepper, green, raw 1 cup 11.0
Potato, baked 1 4.0
Pumpkin, boiled, drained, no salt 1 cup 2.0
Sauerkraut, canned 1 cup 30.7
Spinach, cooked 1 cup 1027.3
Spinach, raw leaf 1 cup 144.9
Spring onion or scallion, raw 1 cup 207.0
Tomato 1 9.7
Turnip greens, boiled, drained, no salt 1 cup 529.3
Watercress, raw 1 cup 85.0
Important Safety Information
  
Back to top
Foods Portion* Vitamin K Content
(micrograms)†
CONDIMENTS AND SWEETENERS
Gelatin 1/2 cup 0.0
Honey 1 tbsp 0.0
Peanut butter 2 tbsp 0.2
Pickle, dill 1 pickle 25.4
Sugar, white, granulated 1 tsp 0.0
Important Safety Information
  
Back to top

Remember…

To keep PT/INR stable and within the recommended range,

  • Take the correct dose of COUMADIN (Warfarin Sodium) at the same time every day
  • Have your PT/INR checked regularly
  • Keep the amount of Vitamin K in your diet consistent from day to day

There are other sources of Vitamin K. Your healthcare provider is your best source of information regarding your health.

*Portions as well as Vitamin K content as specified in USDA database as of November 2007.
†Based on a 2000 calorie diet, the FDA recommends 80 micrograms of Vitamin K daily.
‡Although dried tea leaves are high in Vitamin K content, brewed tea is not a significant source of Vitamin K.

INDICATIONS:

  • COUMADIN® (Warfarin Sodium) is used to help prevent and treat blood clots in the legs, lungs, and those clots associated with heart-valve replacement or an irregular, rapid heartbeat called atrial fibrillation.
  • If you have had a heart attack, COUMADIN may be used to lower the risk of death, another heart attack, stroke, and blood clots moving to other parts of the body.

IMPORTANT SAFETY INFORMATION:

  • COUMADIN can cause serious and life-threatening bleeding. Bleeding is more likely to occur when you first start taking COUMADIN and with a higher dose.
  • Factors that can increase your risk of bleeding while on COUMADIN therapy include being 65 years of age or older, an INR greater than 4, highly variable INRs, history of bleeding involving the stomach or intestine, high blood pressure, certain diseases of the brain, heart or kidney, anemia, cancer, physical injury, taking other drugs, and a long duration of therapy.
  • The PT/INR test checks to see how fast your blood clots. Your healthcare provider will decide what PT/INR numbers are best for you. Your dose of COUMADIN will be adjusted to keep your PT/INR in a target range for you.
  • Tell your healthcare provider right away if you have any signs or symptoms of bleeding problems such as the following: pain, swelling or discomfort, headache, dizziness, or weakness, unusual bruising, nosebleeds, bleeding of gums, bleeding from cuts that take a long time to stop, menstrual flow or vaginal bleeding that is heavier than normal, pink or brown urine, red or black stools, coughing up blood, or vomiting blood or material that looks like coffee grinds.

Back to Top

  • Do not take COUMADIN (Warfarin Sodium) if you are pregnant or plan to become pregnant. COUMADIN can cause death or birth defects to an unborn baby. Use effective birth control if you can get pregnant.
  • Speak to your healthcare provider before breast-feeding while taking COUMADIN.
  • Tell your healthcare provider about all the medical conditions you may have, including recent or planned surgeries or medical or dental procedures.
  • Unsupervised patients with declining mental function due to aging or mental illness, and patients with alcoholism or increased risk of bleeding should not take COUMADIN.
  • Death of skin tissue (skin necrosis or gangrene) is a serious, side effect of COUMADIN. It happens because blood clots form and block blood flow to an area of your body. Call your healthcare provider right away if you have pain, color, or temperature change to any area of your body. You may need medical care right away to prevent death or loss (amputation) of your affected body part.
  • Call your healthcare provider right away if you have pain in your toes and they look purple or dark in color. You may be experiencing a serious condition known as purple toes syndrome.
  • Many factors alone or together such as changes in diet and medicines, including herbal supplements, may affect your response to COUMADIN. Tell your healthcare provider about your diet, all prescription and non-prescription medicines, vitamins, and herbal products you are taking or plan to take. Speak with your healthcare provider before starting, changing, or stopping any of these products. Many drugs, including aspirin and other pain medicines, may interact with COUMADIN (Warfarin Sodium).
  • Eat a normal balanced diet. Do not make changes in your diet, such as eating large amounts of leafy green vegetables, which contain Vitamin K without first talking to your healthcare provider.
  • Avoid alcohol consumption, cranberry juice, and cranberry products while taking COUMADIN.
  • Tell your doctor if you have any illness such as diarrhea, infection or fever.
  • Be aware that COUMADIN and generic warfarin tablets represent the same medication and should not be taken together, as overdosage may result.
  • If you take too much or miss a dose of COUMADIN, call your healthcare provider. Take the missed dose as soon as possible on the same day. Do not take a double dose of COUMADIN the next day to make up for a missed dose.
  • If you have any other questions about COUMADIN (Warfarin Sodium) and your condition, contact your healthcare provider.
Click here for full Prescribing Information

Back to Top

COUMADIN® is a registered trademark of Bristol-Myers Squibb Pharma Company.

COUMADIN (Warfarin Sodium), the COUMADIN color logo, COLORS OF COUMADIN, and the color and configuration of COUMADIN tablets are trademarks of Bristol-Myers Squibb Pharma Company.