Warfarin Care: Blood Monitoring at the Clinic

Many medicines and vitamins can change how warfarin works. Even common products like pain relievers and cold medicines can affect your INR. Always talk to your provider or pharmacist before starting anything new.

Some things to watch for:

• Antibiotics or antifungal medications.
• Pain relievers like ibuprofen or aspirin.
• Herbal products such as ginkgo or St. John’s wort.
• Vitamins and supplements.

Why This Matters: Knowing what interacts with warfarin helps avoid sudden changes in your INR that could lead to bleeding or clotting problems.

You do not need to avoid vitamin K, but you should eat a steady amount each week. Sudden changes in foods like leafy greens can affect your INR.

Foods high in vitamin K include:

• Spinach.
• Kale.
• Collard greens.
• Most green-colored vegetables.

Why This Matters: Keeping your diet steady helps keep your INR steady, which keeps your treatment safe.

Everyone forgets sometimes. If you miss a dose, take it as soon as you remember on the same day. If it is the next day, skip the missed dose. Do not take two doses at once.

Key reminders:

• Take the missed doses the same day.
• Skip it if you remember the next day.
• Never double up.
• Tell your care team if missed doses happen often.

Why This Matters: Taking too much warfarin at once can increase risk for bleeding. Following simple steps keeps treatment safer.

Warfarin can make bleeding more likely, so small habits can help protect you. Be gentle with your gums and skin, and watch for signs of unusual bleeding.

Helpful habits:

• Use a soft toothbrush and electric razor.
• Be careful with sharp tools.
• Watch for bruising, nosebleeds, or dark stools.
• Wear a medical alert bracelet if possible.

Why This Matters: These easy steps lower your risk of injury and help you stay safe while taking warfarin.

Some symptoms need quick attention. Do not wait if you fall, hit your head, or see signs of bleeding or trouble breathing.

Seek emergency care if you have any of the following:

• Heavy or uncontrolled bleeding.
• A bad fall or head injury.
• Sudden chest pain or shortness of breath.
• Sudden weakness/numbness (especially one-sided), trouble speaking or understanding.
• Severe headache, dizziness, balance issues, or weakness.

Why This Matters: Getting help fast can prevent a serious emergency and protect your health.

The Warfarin Center is offered through Peak Vista’s clinical pharmacy services(opens in a new tab). This means your warfarin monitoring, medication support, and prescription needs are connected in one place. Our pharmacy team works closely with your provider to help keep your treatment safe and easy to manage.

What you can expect from our pharmacy services:

• Low-cost medicine: Low-cost options for patients with Medicaid or those paying with cash.
• Right where you get care: Pharmacies located inside select Peak Vista health centers for easy access.
• No extra paperwork: We already have your information as a Peak Vista patient.
• Help with your medicine: Clear instructions for warfarin and other prescriptions.
• Support for long-term health needs: Help with conditions like diabetes, heart health, and blood thinners.
• Delivery to some health centers: Prescriptions can be picked up at select Peak Vista locations.

Why This Matters: Having the Warfarin Center connected to Peak Vista’s pharmacy keeps your care coordinated. It saves time, reduces confusion, and helps you stay on track with your medicines and long-term health.

We do more than fill prescriptions. Our pharmacy team teaches you how to take your medicine safely and works with your doctor to support your long-term health.

Ways we support your care:

• Prescription fills and refills..
• Help with diabetes and heart health programs.
• Free medication programs for qualifying patients.
• Prescription delivery to select health centers.
• Support for medicines used during telehealth visits.

Explore all Peak Vista services(opens in a new tab).

Why This Matters: Extra guidance from the pharmacy helps you manage your conditions more safely and confidently.

Refilling your medicine is simple. Call your pharmacy or stop in, and we will work to get your refill ready as quickly as possible.

Refill reminders:

• Call your pharmacy location directly.
• Allow extra time for medicines that must be ordered.
• If you are out of refills, we will contact your provider.
• Ask about delivery to select health centers.

Why This Matters: Refilling on time keeps your treatment working and helps prevent gaps in care.

Our pharmacy is only for Peak Vista patients. We accept Medicaid and cash payments and offer low prices through a discount program.

Good to know:

• We accept Medicaid and cash.
• Medicare and commercial insurance not accepted.
• No controlled substances.
• Ask about our Patient Assistance Program.

Learn more about Enrollment Services(opens in a new tab) at Peak Vista.

Why This Matters: Knowing your payment options helps you choose the most affordable way to get your medicine.

1. What is a warfarin and why do I need it?
   Warfarin is a medicine that helps prevent harmful blood clots. Your provider may prescribe it if you have a condition that makes clots more likely, such as atrial fibrillation or a history of clots.


2. What is an INR test?
   INR stands for International Normalized Ratio and is a test that checks how fast your blood is clotting/how thin your blood is. This helps your care team make sure your warfarin dose is safe and working the right way.

1. How often will I need INR checks?
   Some patients need weekly testing at first, while others test less often once their numbers are stable. Your pharmacist will tell you how often you need to come in.


2. What should I bring to my appointment?
   Bring a list of all your medicines, vitamins, and supplements. Also tell the pharmacist about any recent health changes or new foods you have been eating.


3. Who will I see at my appointment?
   You will see a specially trained clinical pharmacist who works under protocols created with Peak Vista providers. They work with your doctor to help you stay safe on warfarin.

1. Can I eat foods with Vitamin K?
   Yes. You do not need to avoid these foods. You just need to eat a steady amount each week. The Warfarin Center can help you determine how much and what types of vitamin K to consume for your dietary preferences.


2. What if I forget to take my warfarin?
   If you remember on the same day, take the missed dose. If it is the next day, skip it and take your regular dose. Do not take two doses at once.


3. Can I drink alcohol while taking warfarin?
   Alcohol can affect how warfarin works and increases your risk for bleeding. Talk with your care team(opens in a new tab) about what is safe for you.

1. How can I help my child eat healthy and stay active?
   Some pain medicines, like ibuprofen,naproxen, or aspirin, can affect your INR or increase bleeding. Always ask your provider or pharmacist before taking any new medicine.


2. Do vitamins or herbal products affect warfarin?
   Yes. Many vitamins and herbal products can change how warfarin works in your body. Some can make your blood too thin, while others can make it clot too fast. Even products that seem harmless can affect your INR.
   
   Things to keep in mind:
   1. Vitamin K can lower your INR if you take more than usual
   2. Herbal products like ginkgo, garlic pills, St. John’s wort, and ginseng can change your INR
   3. "Natural” or “plant-based” does not always mean safe with warfarin

1. What signs of bleeding should I watch for?
   Call your provider if you notice nosebleeds, vomiting blood, dark stools, unusual bruising, or heavy periods. Get help right away for very bad bleeding or after a hard fall.


2. How do I get started at the Warfarin Center?
   Your Peak Vista provider(opens in a new tab) must refer you. Once the referral is made, the center will contact you to schedule your visits.

1. Can I pick up my warfarin from the Peak Vista pharmacy?
   Yes. If you are a Peak Vista patient and use the Peak Vista pharmacy, your prescription can be filled there. Ask the pharmacy team if you have questions about cost or refills.


2. How do I refill my warfarin prescription?
   Refilling your warfarin prescription is simple. You can call or stop by your Peak Vista pharmacy to request a refill. If you are out of refills, the Warfarin Center pharmacists can approve and order your refills.
   
   Helpful reminders:
   1. Call your pharmacy a few days before you run out
   2. Allow extra time if your medication needs to be ordered.
   3. Ask about delivery to select Peak Vista locations.