Sudden increase in vitamin k may decrease the effect of coumadin.
Before you take any new drug including over-the-counter medicationsherbal productsvitaminsnutritional supplementsor medication prescribed by another doctor or dentist check with the doctor who monitors your warfarinHe may need to change your dosageOr he may recommend another medication less likely to interfere with warfarin.
The S-enantiomer of warfarin is mainly metabolized to 7-hydroxywarfarin by CYP2C9a polymorphic enzymeThe variant allelesCYP2C9*2 and CYP2C9*3result in decreased in vitro CYP2C9 enzymatic 7-hydroxylation of S-warfarinThe frequencies of these alleles in Caucasians are approximately 11and 7for CYP2C9*2 and CYP2C9*3respectively.
Grapefruit juicecranberry juicenoni juiceand pomegranate juice may interact with warfarin and lead to unwanted side effectsAvoid the use of these juice products while taking Coumadin.
The anticoagulant effect of COUMADIN persists beyond 24 hoursIf a patient misses a dose of COUMADIN at the intended time of daythe patient should take the dose as soon as possible on the same dayThe patient should not double the dose the next day to make up for a missed dose.
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office of dietary supplements important information to know when you are taking coumadin and vitamin k.