A patient at risk for recurrent blood clots may be placed on oral warfarin, also known by the brand name Coumadin. Patients with mechanical heart valves also will need to take life-long warfarin. This drug is effective in preventing blood clots and requires careful monitoring. Warfarin can also have dangerous interactions with other medications. It is important to work closely with a physician while taking warfarin as some side effects are life-threatening.
Bleeding
Patients on warfarin are at risk for bleeding if they are injured. A small paper cut can take a long time to stop bleeding because the blood cannot clot. A more significant open wound can be life-threatening because of significant hemorrhage. According to MayoClinic.com, it is important to try to decrease the risk of falls and avoid contact sports as internal bleeding can occur. A subdural hematoma or bleeding in the brain is a life-threatening event and needs emergent care. Certain herbal supplements such as fish oil, garlic, ginseng and St. John's wort can interact with Coumadin and increase the risk of bleeding.
Embolisms
Coumadin can actually cause the problem it is trying to prevent,. blood clots, or embolisms. Arthroemboli or cholesterol emboli can shed and cause abrupt foot or leg pain, foot ulcers, penile gangrene and abdominal pain. The most commonly involved organs are the kidneys, pancreas, liver and spleen. Emboli to these organs can cause pancreatitis, renal insufficiency and hypertension. Any symptoms of vascular compromise such as numbness, tingling, discoloration of the digits or skin should be reported immediately to a physician.
Purple Toe Syndrome
According to Bristol Meyers Squibb, manufacturers of Coumadin, purple toe syndrome is usually noted between three and 10 weeks after initiation of therapy. Features of this syndrome include purple coloration of the bottom of the feet and sides of the toes which blanch with pressure. There may be pain and tenderness in the feet and the discoloration may wax and wane. This syndrome is reversible but there are reports noting progression to necrosis and gangrene. This syndrome needs to be reported to a physician.
Member Comments