How can I make sure I take Coumadin safely after knee replacement surgery?

After knee replacement surgery, take Coumadin exactly as your doctor instructs. It's important to have just the right level in your blood. If the Coumadin blood level gets too high, you might bleed too easily. If it gets too low, your blood might form a clot in your veins.

Blood testing: Your doctor will regularly order a blood test to monitor your Coumadin levels. This blood test is called a PT/INR, and it measures the ability of your blood to clot. The test may use blood from a finger stick or regular blood draw.

Eating plan: Since there are many foods that affect Coumadin, you may need to make some changes to your diet.
Travis M. Hendry, MD
Orthopedic Surgery
Coumadin needs to be managed carefully. Many factors can dramatically affect how it works, including small changes in dose or dose timing, what you eat or drink, other medications you take, illness, or stress. You and your doctor must work closely together to manage it. Always follow your doctor's instructions exactly. Here are some guidelines:
  • Take your Coumadin once a day, at the same time every day. Many doctors prefer you take it in the evening. Use a pill box and a daily dosing chart to help you stay on schedule.
  • If you forget to take a dose, take it as soon as you remember. If it's already time for the next dose, don't take a double dose to catch up. Just skip the missed dose, and tell your Coumadin provider at your next appointment.
  • Your dose may need to be adjusted often at first. Be sure to get your laboratory tests when they're recommended.
  • Tell all your health care providers, including your dentist, that you're taking Coumadin. They need to know this before prescribing anything else.
  • Do not take aspirin, medications that contain aspirin, or pain relievers known as nonsteroidal anti-inflammatory drugs, or NSAIDs (ibuprofen, Advil, or Aleve). You may take acetaminophen (Tylenol).
  • Check with your Coumadin provider before starting or stopping any other medications, including prescriptions, over-the-counter medications, or supplements.
  • Be very consistent in the amount of foods with vitamin K that you eat.
  • Limit alcohol to two drinks a day. Limit cranberries and cranberry juice. Don't eat grapefruit or drink grapefruit juice.
  • Avoid binge eating and crash diets.
  • Check with your Coumadin provider before travelling, as this might affect your medication availability, scheduled tests, and eating habits.
  • Do not become pregnant while taking anticoagulation medication.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.