warfarin heart surgery are put on warfarin .

Patients who are on warfarin need to be aware of the effects of warfarin . 

Patients undergoing valve replacement with a mechanical valve will need tobe put on warfarin lifelong . 

Foods containing vitamin k can affect how warfarin works . 

They include green leafy vegetables 

Brocoli spinach and lettuce 

Chickpeas 

Liver 

Egg yolks 

Mature cheese 

Avocado 

Olive oil 

Eating in moderation is recommended .

Cranberry and grapefruit avoided . 

Dosage .depends on body weight to be taken in evening . Start with 10 mg and then reduce gradually . Daily inr is a must . Different indication have varied dosage . 

Effect of warfarin to manifest takes 48 hours . So patients are put on heparin to bridge the gap . 

Regular blood test of inr is needed to titrate dosage of warfarin . High inr suggests the time taken to clot as compared to normal. 

Every day inr level is required till the target is reached . Then inr will be needed every 12 weekly .

Warfarin interacts with other medications too . 

Medicines such as amiodarone and quinidine for heart . 

Non steroidal anti inflammatory like ibuprofen ,aspirin 

Cholesterol lowering agents benzafibrate, clofibrate 

Antibiotics such as erythromycin , cotrimoxazole , norfloxacin 

Miconiazole 

It is safe to take paracetamol. 

Warfarin is not reccomended during pregnancy . If required then it has to be taken under supervision if doctor says baby is healthy then it is ok to take warfarin . Cause of concern if baby bleeds or bruise easily . Baby is not feeding well  then go to doctor .