When first taking anticoagulants, patients should avoid operating heavy machinery (e.g., driving) until they know how the medication may affect them. Patients should remember that anticoagulants can control many conditions, but do not cure them. Patients should continue to take their medication exactly as directed and to keep all scheduled follow-up appointments with their physician.

Especially at the beginning of therapy, patients taking anticoagulants need to undergo regular blood tests to monitor their dosage. These tests usually require the patient to visit a hospital, physician’s office or laboratory regularly. Newer devices allow patients to monitor their medication at home.

Patients on anticoagulants need to avoid cutting themselves, including when shaving, brushing their teeth (a soft toothbrush is recommended) or flossing, because their blood will not clot as effectively. Similarly, patients are advised against playing contact sports (e.g., football) or any other activity where there is risk of injury (e.g., skiing or motorcycle riding).

Vitamin K plays an integral role in blood clot formation and inhibits the action of anticoagulant medications. Dosages of these medications will therefore depend on the levels of vitamin K in the patient’s diet. Patients should not make any changes to their diet that would greatly increase or decrease their levels of vitamin K intake without consulting with their physician, who may need to alter the dosage of the anticoagulants. Vitamin K is most prevalent in green leafy vegetables (including spinach, broccoli, cabbage, kale and lettuce) and some vegetable oils.

Care should also be exercised in patients with Factor V (five) Leiden. This is a variation in a gene that affects the clotting process, increasing coagulation. Factor V Leiden is the most common inherited blood disorder in the United States. It is present in 4 to 6 percent of Caucasians; 2 percent of Hispanic Americans; a little over 1 percent of African Americans and Native Americans and about 0.5 of one percent of Asian Americans. Treatment is typically unwarranted unless there is evidence of a blood clot, in which case warfarin or other anticoagulants are prescribed. Depending on the situation, anticoagulants may be recommended to help afford advance protection against the development of blood clots. For example, women with a Factor V Leiden mutation may be advised to take anticoagulants during pregnancy and in the postpartum period.