Warfarin and Its Side Effects

Have you ever played any sport and scraped a body part to the point where you bleed slightly? I have had plenty of scrapes playing sports. The interesting part about my scrapes is you start to bleed, but a few minutes later, the blood clots and starts to dry. Your body naturally patches the skin to prevent blood from leaving your body.

Warfarin (Coumadin) is a drug that prevents blood clotting (thrombosis) from happening. A lot of people think that Wafarin is a blood thinner since the blood continues to flow but in actuality, it is an anti-coagulant which doesn’t affect the density or flow of blood at all. Any time your skin is punctured, blood starts to ooze out of your body. Your blood has enzymes and vitamin K that enable it to bond together (clot) to the skin cells at the puncture point. Of course, this is a simplified version of the whole process. Warfarin affects the ability of your liver to process vitamin K for blood clotting.

Why Is This Good? 

One would think that preventing a blood clot will cause you to bleed indefinitely. This can be true but Warfarin is not designed for internal functions. Picture this; a blood clot develops in a vein near your heart. Blood thinners won’t work since they just take care of blood flow and the blood would just go around the clot. The clot becomes dangerous since it can potentially cut off blood to a vital organ and cause a heart attack or organ failure. Warfarin would be used to clear the blood clot by unbinding the cells over time and restore blood flow. Warfarin functions better when there is slow moving blood (veins) and near valves. A fun fact about Warfarin is that is was originally used as a pesticide against rats and mice.

Warfarin Can’t Be All Good?

Warfarin has side effects even though it is designed to help us. The obvious side effect is hemorrhaging (bleeding) in a deep cut. Obviously, if you can’t stop the bleeding, your chances of survival are reduced. This would require a need to be careful if playing sports. In rare cases, you can cough up blood, have it run from your nose and find blood in your urine and stool samples. Then there is the possibility of purple toe syndrome. I guess they couldn’t come up with a better scientific name but in essence your toe or parts of your foot turns purple due to cholesterol build-up and can be painful.

Another side effect is that you have to monitor your meals. Any food containing vitamin K will prevent Warfarin from doing its job. Foods to avoid include: spinach, parsley, brussel sprouts (still not a fan), green tea, cabbages, kale (green vegetables), garlic, ginger, cranberry juice and alcohol. I think for most, the main worry is alcohol consumption. Unfortunately, that beer after a hard day working might make things worse for you.

Warfarin Interactions

Warfarin interacts with a lot of drugs. I can write about all the interactions but this post would be over 10 pages long. Prescription drugs such as simvastatin, aspirin and broad spectrum antibiotics can interfere with Warfarin and cause bleeding or bruising.

The one thing I learned about studying Warfarin is that pregnant women should avoid it. It just doesn’t react well with fetuses since Warfarin passes the placental barrier. As a recap, Warfarin prevents clotting and increases bleeding, therefore it can cause bleeding in the fetus and prevent proper development. Warfarin is associated with stillbirth, spontaneous abortion and neonatal death.

If you manage to outlast those side effects, then you have the possiblilty of skeletal and limb abnormalities in the first trimester. Once you pass onto the second and third trimester, the side effects are less likely to happen. The most common would be central nervous system disorders, seizures and eye defects. Based on this information, is the risk