Summary: Leaving the hospital when taking Coumadin is a transition from one environment to another so Coumadin doses can change, sometimes markedly. Get a blood test, an INR (or PT), very soon after you leave. Knowing the INR within 36 hours of leaving the hospital may save you a trip to the emergency room if the INR is shifting away from the desired level for you. Your diet, your activity and other medicines can easily change your sensitivity to the Coumadin. The list of potentially interacting drugs is very long, but for most of the drugs, you may not be sensitive to a change in Coumadin on or off other drugs. Some drugs however are often modifiers of your need to change Coumadin doses; these drugs include antibiotics 9such as Septra for a UTI) and amiodarone, a heart medicine. Get your tests in one laboratory; the INR does vary between labs. If your physician uses a laboratory that does INR tests on blood taken from the elbow area, that test may take hours to get back. In that case, I would prefer to have early hour appointments with the doctor or at least an early visit to the laboratory, and I would avoid Fridays to decrease the chances of not being called with the INR and Coumadin adjustments over the weekend. Whenever you leave the hospital, have the contact information for your physicians. Also, be responsible for yourself. Know what the next steps are in your care, and when your next visit to the doctor or doctors are. Get a discharge summary (which will include your hospital identification number and the hospital’s medical record number assigned to you as well as your diagnoses at discharge), have a list of all your medicines, know which ones may be interacting with the Coumadin, and what happens to the INR and Coumadin if one of the medicines is modified or stopped after discharge.
