Integrated Care Partnership


Dr S Emanuel – Anticoagulation Clinic
For Appointments Call: 01372 847331 (Patti)
For Advice Call: 01372 724434 (Dr Emanuel or Sister Alison Reed)

For Emergency Call: A&E 01372 735 735 ext. 6006

Anticoagulant Check List
You Should:

  1. Report any signs of bruising or bleeding.
  2. Have regular blood tests.
  3. Take your anticoagulant at the same time each day.
  4. Take the dose of anticoagulant as prescribed.
  5. Inform your clinic of any new medicines you are taking (including alternative and over the counter medicines).
  6. Eat a balanced diet.
  7. Carry a record of your anticoagulant dose with you.
  8. Remind your doctor/dentist/pharmacist that you are taking an anticoagulant.

You Should Not:

  1. Take aspirin or medicines containing aspirin unless advised to do so by your doctor.
  2. Take more than moderate amounts of alcohol.
  3. Miss a dose of anticoagulant unless advised to do so.
  4. Take extra doses or change your dose of anticoagulant.
  5. Run out of anticoagulant tablets.

Common questions concerning your anticoagulant:

What is an anticoagulant?
An anticoagulant is a medicine that stops blood from clotting in the blood vessels of the body, helping to maintain normal blood flow.

Are there any side effects?
Most importantly, YOU SHOULD look out for any signs of bruising or bleeding (listed below) and report them to the anticoagulation team or your doctor AS SOON AS POSSIBLE.

Anticoagulant side effects:-
Long term headaches Bleeding from gums
Nose bleeds Blood in vomit
Red or black stools Pink urine
Blood shot eyes Excessive bruising
Blood in sputum Hair loss

Women should look out for any abnormally heavy menstrual bleeding. Rare minor side effects may include loss of appetite, nausea, mild diarrhoea, or rash.

How long will I need to take the anticoagulant medication?
The length of time will depend on the reason for you being on the anticoagulant. This will be decided by your doctor when you are started on the anticoagulant medication.

When should I take the anticoagulant?
You should take the anticoagulant once a day, at roughly the same time. We would advise that the anticoagulant be taken at about 6pm.

What dose of anticoagulant should I take?
The amount of anticoagulant you are prescribed is based on the result of a regular blood test called an INR (International Normalised Ratio). This blood test allows us to measure the time it takes for your blood to clot.

You will be advised of the dose of anticoagulant to maintain your INR within a set range. This INR range will depend on your reason for being on the anticoagulant. You may find that your dose of anticoagulant may change frequently in order to maintain your INR within the range.

How often will I need to have an INR blood test?
This will depend on how stable your previous blood tests have been. You will need to have up to weekly INR blood tests when you begin taking the anticoagulant medicine. Blood tests may be less frequent as your INR becomes more stable.

It is VERY IMPORTANT that you have regular blood tests to check the dose of anticoagulant you need. You should tell your doctor or your anticoagulation team if you are not able to attend and make another appointment as soon as possible.

Can I take other medicines while I am on an anticoagulant?
When buying over the counter medicines, ask to speak to the pharmacist and tell them that you are taking an anticoagulant

If you are started on antibiotics you should tell the anticoagulation team and have an IINR blood test no longer than 5 days after starting the course. These medications commonly upset the balance of your anticoagulation.

Aspirin containing medicines should only be taken if prescribed by your doctor. It is safer to avoid non-steroidal anti-inflammatory drugs (NSAID) like diclofenac or ibuprofen as they can increase the risk of bleeding from the stomach. Occasional paracetamol for headaches is acceptable.

Can what I eat affect my Anticoagulant medication?
It is important that you eat a well-balanced diet, which has moderate amounts of foods containing vitamin K (listed below). These foods are important in your diet, but taking them in excess may lower your INR blood test. DO NOT go on crash diets or start “binge” eating.

Vitamin K rich foods:-
Cabbage Chives Brussel sprouts/tops
Spinach Cauliflower Turnip greens
Watercress Lettuce Spring onions
Green beans Asparagus Broccoli
Avocado Chickpeas Rape seed oil
Soya bean oil Liver Egg (yolks)
Mature cheeses Cereals (wheat bran & oats)

Can I drink alcohol while I am taking an anticoagulant?
You SHOULD NOT take more than moderate amounts of alcohol (2 units of alcohol daily, “1 pint or 2 shorts or 2 glasses of wine”). You should avoid “binge” drinking, – It Is very dangerous.

What should I do if I am injured while taking anticoagulants?
In the event of a minor injury apply constant pressure to the site for at least 5-10 minutes using a clean, dry dressing. If you are unable to stop the bleeding or have a major injury seek medical help immediately.

What should I do if I require an operation or dental treatment?
While you are taking an anticoagulant drug you are at a higher risk of bleeding. If you require any treatment you should make your doctor or dentist aware that you are taking an anticoagulant well in advance. Contact your anticoagulant clinic or doctor for further advice. Carry your anticoagulant card with you.

What should I do if I think I may be pregnant?
Oral anticoagulant medicines taken during the early weeks of pregnancy may damage the unborn child therefore, if you are a female of childbearing age you SHOULD NOT plan a pregnancy without consulting your doctor.

If you think you may be pregnant while taking an oral anticoagulant do not delay contact your doctor immediately for advice.