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Food Interactions with Coumadin, Warfarin

Author:   Peter Sedesse MD

The Purpose of Coumadin

Coumadin is a blood-thinning medication used to treat and prevent blood clots. Coumadin is also known as Warfarin and is normally prescribed for people who have blood clots, who are at risk of developing blood clots in their arms or legs, and Coumadin is also generally prescribed following many surgeries. This is done to prevent blood clots from reaching organs where they can cause serious complications like a stroke or pulmonary embolism in the lungs. Warfarin works by interacting with the body´s normal clotting mechanism, for this reason, any food that also has an effect on clotting could interfere with the purpose of the medication.

Coumadin, Vitamin K and Blood Clotting

The most important nutrient involved with blood clotting is Vitamin K. In the past, individuals who were given Coumadin were also placed on low Vitamin K diets, however, research done recently has shown that normal levels of Vitamin K consumed in food has no effects on Coumadin effectiveness. It is still advisable for individuals on Coumadin to know which foods contain high amounts of Vitamin K, because eating high amounts of these foods could have some risks of an interaction with Coumadin.

The only really dangerous food that can interact with Coumadin in modest amounts is green tea and any foods related to it. There are many other foods that contain modest amounts of Vitamin K that only may become a problem if they are eaten in large portions, or eaten frequently within a short period of time. These foods are normally some of the healthiest foods you can eat like spinach, broccoli, kale and other dark green vegetables. It is not necessary to eliminate them from your meal plans while you are taking Coumadin, just be careful of eating large portions.

Problems Caused when Foods Interact with Coumadin and Warfarin

The problem Vitamin K causes when interacting with Coumadin is that it may prevent the medicine from working as intended. There are also foods and substances which should be avoided for the opposite reason, they provide a similar effect. The danger of this is that it can cause wounds to not close normally leading to excessive blood loss, and in some situations, it can cause internal bleeding without any injury. This is most likely to occur in the intestines. For this reason, it is important to check your feces after each bowel movement to make sure their is no blood present. The feces will appear either bright red, which is clearly the sign of bleeding, but if the wound is near the beginning of the digestive tract, the blood will actually appear black and tar-like. It is very important to notify your doctor of any changes in the appearance of your feces while on Coumadin.

Foods That Enhance Coumadin and Warfarin

There are two main food culprits that may cause this to happen, they are cranberries and alcohol. Cranberries contain a rather unique chemical that enhances the effect of Coumadin. Alcohol on the other hand simply causes similar effects to as Coumadin. Both foods should be avoided while on Coumadin. While not a food, it is also important to note that Aspirin has similar blood thinning effects like Coumadin, and should be avoided.

Smoking and Coumadin

Although this article is about the interaction of foods with Coumadin and Warfarin, it is important to mention smoking also. The different chemicals that enter your body when you smoke have differing effects on blood clotting and blood pressure. The result of this is that smoking while on Coumadin can result in the effectiveness of the Coumadin swinging widely up and down. In other words, a smoke on Coumadin runs the risk of having the Coumadin be ineffective, and thus not able to block harmful clots, or also have the Coumadin be too effective and result in excessive bleeding or internal bleeding.

Food can effect Coumadin in two different ways, it can make the Coumadin too effective, or it can block its effects. The foods that block the effects of Coumadin mainly involve high Vitamin K foods like green tea, and to a lesser degree dark green vegetables. Foods that compound or enhance the effects are cranberries and alcohol. Aspirin is another chemical the compounds the effects of Warfarin, while smoking can cause both bad outcomes to happen.

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