Management of Dietary Interactions and Vitamin K: dietary consistency is the key to maintaining a sustained, stable response during warfarin therapy. Patients should be aware of vitamin K content in common foods, particularly foods high in vitamin K (green leafy
vegetables (broccoli, Brussel sprouts, turnip greens, kale, spinach, beet
greens), Cauliflower , legumes, mayonnaise, canola and soybean oils), and should maintain a consistent amount of these foods in their diet.
The following foods should be avoided or limited, since they also can effect
warfarin therapy: caffeinated beverages (cola, coffee, tea, hot chocolate, chocolate
Alcohol intake greater than 3 drinks daily can increase the effect of
Coumadin. As long as
alcohol intake does not exceed 3 drinks daily, clotting times should not be affected. This
amount of alcohol is present in 12 ounces of table wine or three 12
ounce beers. (Acute binges can raise INR. Chronic alcohol ingestion may decrease
Herbal supplements can affect bleeding time.
Coenzyme Q10 is an herbal supplement whose chemical structure is similar to vitamin K, so it has the potential to affect
bleeding time. Herbal teas: green tea, buckeye, horsechestnut,
tonka, bean, meliot, and woodruff.
Other examples include: feverfew, garlic, and ginseng. Herbal medications should either be avoided or used consistently while on warfarin therapy.
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