Coumadin

Special warnings about Coumadin

Treatment with blood thinners may increase the risk that fatty plaque will break away from the wall of an artery and lodge at another point, causing the blockage of a blood vessel. If you notice any of the following symptoms, contact your doctor immediately:

Abdominal pain; abrupt and intense pain in the leg, foot, or toes; blood in the urine; bluish mottling of the skin of the legs and hands; foot ulcers; gangrene; high blood pressure; muscle pain; "purple toes syndrome" (see below); rash; or thigh or back pain.

If you have any of the following conditions, tell your doctor. He or she will have to consider the risks against the benefits before giving you Coumadin.

An infectious disease or intestinal disorder
A history of recurrent blood clot disorders in you or your family
An implanted catheter
Dental procedures
Inflammation of a blood vessel
Moderate to severe high blood pressure
Moderate to severe kidney or liver dysfunction
Polycythemia vera (blood disorder)
Severe diabetes
Surgery or injury that leaves large raw surfaces
Trauma or injury that may result in internal bleeding

Purple toes syndrome can occur when taking Coumadin, usually 3 to 10 weeks after the start of anticoagulation therapy. Symptoms include dark purplish or mottled color of the toes that turns white when pressure is applied and fades when you elevate your legs, pain and tenderness of the toes, and change in intensity of the color over a period of time. If any of these symptoms develop, notify your doctor immediately.

If you are taking Coumadin, your doctor should periodically check the time it takes for your blood to start the clotting process (prothrombin time). Numerous factors such as travel and changes in diet, environment, physical state, and medication may alter your response to treatment with an anticoagulant. Clotting time should also be monitored after your release from the hospital and whenever other medications are started, discontinued, or taken sporadically.