Eating more or less of certain foods can affect cogulation.
Aagulant effect of Coumadin, which means people taking the blood thinner need to watch their diet.
Key point: Changing daily meals and snacks/supplementation can have a major effect on vitamin K levels and hence INRs, says Tom Snader, PharmD, CPG, a consultant in North Wales, Pa.
Many green vegetables, such as spinach, peas, Brussels sprouts, kale, and broccoli, have significant amounts of vitamin K in them. So does Boost, the nutritional supplement, and green tea.
Resource: For a comprehensive list of foods with high, medium and low vitamin K content, go to www.ptinr.com/docs/Vit_K_registry.pdf.
The person on Coumadin should maintain a consistent dietary intake of vitamin K and avoid "wide swings," advises Linda Young, MS, RD, LMNT, an assistant professor of practice at the University of Nebraska-Lincoln. "Patients and their families should also receive instructions at discharge from the nursing facility about this dietary issue," Young tells Eli. Otherwise, a person might eat more fresh vitamin-K rich produce in the summer, for example, when it's more readily available, she cautions.
Good idea: Also ask the resident's family or visitors to check with you before bringing the person snacks or meals or before they take the resident out on a therapeutic leave of absence.
Discharge teaching tip: Remind residents on Coumadin and their families to check with their physician after discharge before taking any medication, including aspirin, or over-the-counter supplements. In addition to vitamin K, supplements that can interact with warfarin, according to Mayoclinic.com, include:
• Fish oil and omega-3 supplements
• Bromelains
• Coenzyme Q10 (ubidecarenone)
• Cranberry extracts
• Danshen
• Dong quai
• Garlic
• Ginkgo
• Ginseng
• St. John's wort
Resource: Check out a cookbook with recipes for patients on Coumadin: www.coumadincookbook.com/
