coumidin, the medicine

What foods should be avoided when taking coumidin?

[skydnsr]

Contrary to popular belief, you don't need to avoid any particular foods when you are on coumadin.  You need to eat like you normally eat, so that your coumadin dose can be adjusted around whatever your typical intake is.  It makes no sense for someone else to set an arbitrary dose for you and then expect you to control your diet to keep from upsetting that dose.  Let your diet determine the dose.  Most people's food likes and dislikes don't change that much, so your diet will tend to stay pretty stable over time, if you just eat what you like.  If you eat green vegetables every day, great.  They are good for you, and your coumadin dosage can be adjusted to account for that.  

You don't need to stress to try to eat exactly the same amount of vitamin K every day, either.  You won't be able to do it, and you don't need to.  Coumadin is a long-acting drug, so you only need to eat approximately the same amount of vitamin K in your diet over about a week to 10-day period as you did in the previous week to 10-day period.  Your INR range is just that, a range.  So if your vitamin K intake varies from day to day, your INR will probably still be within your prescribed range, as long as there weren't any really wild or sustained changes in your diet.  A spinach salad here and there is not going to make any difference.

You do need to try to avoid drastic dietary changes, or at least if there is a drastic change, you need to get your INR tested more frequently until things stabilize.  If you go on a weight loss diet, for instance, you may well change your vitamin K intake enough to impact your INR significantly.  Things like illness or travel can also cause dietary disruption.  Also, soy oil has a lot of vitamin K in it, so if you suddenly start (or stop) eating or drinking a lot of soy products (including salad dressing made with soy oil), that can necessitate a change in coumadin dosage.   Energy bars are notorious for having enough vitamin K in them to cause a significant shift in INR, so if you start eating an energy bar every day, look out.  Binge drinking is absolutely out, although light drinking can be okay -- if you have no other reason to avoid light drinking.  If your alcohol intake is excessive or out of control, then you need to get help and just stop drinking.  Some people say that starting or stopping an exercise program can change your INR.

There are a lot of medications that can affect your INR.  The ones that you take all the time will be accounted for in your normal coumadin dose, just like the foods that you eat all the time will be automatically accounted for.  The drugs that tend to cause problems with INR are the ones that are new to you or  that are temporary, like antibiotics.  Again, get your INR tested more frequently if you are on a new medication, so you and your doctor will be able to see if a change in your coumadin dosage is going to be necessary.

Coumadin dosage adjustments are based on the INR test results, not based on what you put in your mouth.   So if you are unsure whether you need a dosage change, then test and don't guess.  Oftentimes I have thought, oh my INR is going to be up or down, because I did this or that, and then the result will still be right in range.  Other times, my INR has unexpectely gone up or down, and I have no idea why.

For more information on coumadin management, see www.warfarinfo.com.  It is run by Al Lodwick, who is a very knowledgable retired pharmacist.  He worked fulltime as an anticoagulation therapy (ACT) manager for many years.  Now he is employed by Cross Country Education seminars, and he goes around the country providing continuing education on coumadin-related topics to medical professionals.

Good luck.