Diet and Warfarin

饮食和华法林 Diet and Warfarin Your doctor has prescribed the medicine warfarin (brand names Coumadin and Jantoven) for you. It is an anticoagulant (blood thinner) that makes your blood clot more slowly to prevent dangerous problems, such as a stroke. Your doctor can tell how well warfarin is working from a blood test, called international normalized ratio (INR). The test shows how quickly your blood clots. There are some foods, including those rich in vitamin K, alcohol, some dietary and herbal supplements, as well as some medicines, that can affect the way warfarin works in your body. 医生为您开有药物华法林 ( 品牌名称 Coumadin 和 Jantoven) 这是一种抗凝血剂 ( 血液稀释剂 ), 可减缓血液凝结, 防止发生中风等危险情况 医生可通过一项名为国际标准化比值 (INR) 的血液检测了解华法林的疗效 此检测可显示您的血液凝结速度 某些食物可能影响华法林在您体内的作用, 包括富含维生素 K 的食物 酒精 某些膳食补充剂和草药补充剂以及某些药物 Foods rich in vitamin K To help warfarin work well, it is important to keep your vitamin K intake as consistent as possible. A large increase in vitamin K can lower your INR to cause dangerous clotting in your blood. A large decrease in vitamin K can raise your INR to make it harder for your blood to clot. This could cause you to bleed too much. You do not need to avoid or follow a diet low in vitamin K while taking warfarin. To keep your INR stable and within your recommended range: Take warfarin exactly as your doctor directed. Have your INR checked regularly. The test is done at least monthly. 富含维生素 K 的食物 为了使华法林有效产生作用, 务必使您的维生素 K 摄入量尽量保持稳定 维生素 K 摄入量大幅增加可能使 INR 降低, 导致血液发生危险凝结 维生素 K 摄入量大幅减少可能使 INR 升高, 导致血液难以凝结 这可能导致您失血过多 服用华法林时, 您无需避免或采用维生素 K 含量低的饮食 为了使 INR 稳定并保持在针对您的建议范围内 : 准确遵医嘱服用华法林 定期检查 INR 此检查至少每月进行一次

2 patienteducation.osumc.edu Keep your vitamin K intake consistent week to week. For example, you may plan to eat of foods rich in vitamin K per day. If you like to eat these foods and eat them often, you can eat them, but be consistent. Do not make any major changes in your intake of foods rich in vitamin K. For example, if you eat a spinach salad every day, do not stop eating it entirely. Discuss vitamin supplements with your doctor. Do not take more than 1 supplement that contains vitamin K. 食物 Food 羽衣甘蓝 ( 熟 ) Kale, cooked 欧芹 ( 生 ) Parsley, raw 菠菜 ( 熟 ) Spinach, cooked 芥菜 ( 熟 ) Mustard greens, cooked 甘蓝叶 ( 熟 ) Collards, cooked 瑞士甜菜 ( 熟 ) Swiss chard, cooked 萝卜叶 ( 熟 ) Turnip greens, cooked 瑞士甜菜 ( 生 ) Swiss chard, raw 球芽甘蓝 ( 熟 ) Brussels sprouts, cooked 西兰花 ( 熟 ) Broccoli, cooked 卷心菜 ( 熟 ) Cabbage, cooked 甘蓝叶 ( 生 ) Collards, raw 富含维生素 K 的食物 Foods Rich in Vitamin K 食物量 Food Amount 使每周的维生素 K 摄入量保持稳定 例如, 您可计划每天食用 富含维生素 K 的食物 如果您喜爱食用此类食物且经常食用, 您可以食用, 但务必保持稳定 Ì 不要使富含维生素 K 的食物摄入量发生任何重大变化 例如, 如果您每天食用一份菠菜沙拉, 则不要突然完全停止食用 Ì 与医生讨论维生素补充剂的使用 不要服用多种含有维生素 K 的补充剂 维生素 K( 微克 ) Vitamin K (mcg) 531 492 444 415 387 287 265 150 150 110 82 79

patienteducation.osumc.edu 3 食物 Food 球芽甘蓝 ( 生 ) Brussels sprouts, raw 菠菜 ( 生 ) Spinach, raw 芥菜 ( 生 ) Mustard greens, raw 萝卜叶 ( 生 ) Turnip greens, raw 菊苣 ( 生 ) Endive, raw 羽衣甘蓝 ( 生 ) Kale, raw 西兰花 ( 生 ) Broccoli, raw 金枪鱼, 罐装油浸 Tuna, canned in oil 卷心菜 ( 生 ) Cabbage, raw 西梅 ( 炖 ) Prunes, stewed 罗马生菜 ( 生 ) Romaine lettuce, raw 绿叶生菜 Green leaf lettuce 豌豆 ( 熟 ) Peas, cooked 牛油果 Avocado 芦笋 Asparagus 黑莓 ( 生 ) Blackberries, raw 蓝莓 ( 生 ) Blueberries, raw 富含维生素 K 的食物 Foods Rich in Vitamin K 食物量 Food Amount 3 盎司 3 ounces 维生素 K( 微克 ) Vitamin K (mcg) 78 73 72 69 58 57 45 37 34 33 29 23 19 16 16 15 15

4 patienteducation.osumc.edu If you greatly increase or decrease foods rich in Vitamin K in your diet, let your doctor know right away. If your INR levels are hard to manage, meet with a dietitian to review the vitamin K content of your diet. 如果您饮食中富含维生素 K 的食物显著增加或减少, 请立即告诉医生 如果您的 INR 水平难以控制, 请咨询营养师以检查您饮食中的维生素 K 含量 Cranberries Moderate amounts of cranberry products are fine, such as one, 8-ounce glass of cranberry juice a day. Avoid eating or drinking large amounts of cranberries, cranberry juice, and cranberry supplements while taking warfarin. Grapefruit Do not eat grapefruit or drink grapefruit juice while taking warfarin. Alcohol Alcohol should be avoided. Talk to your doctor if you have questions. Dietary and herbal supplements Taking herbal supplements may cause problems and affect how your body uses warfarin. Avoid these herbal supplements: Alfalfa Arnica Bilberry Butchers broom Cat s claw Coenzyme Q10 Dong quai Echinacea 蔓越莓 可适量食用蔓越莓制品, 如每天喝一杯 8 盎司的蔓越莓汁 服用华法林期间, 避免大量食用或饮用蔓越莓 蔓越莓汁以及蔓越莓补充剂 葡萄柚 服用华法林期间, 不要食用葡萄柚或饮用葡萄柚汁 酒精 应当避免饮酒 如有疑问, 请咨询医生 膳食补充剂和草药补充剂 服用草药补充剂可能导致问题, 影响人体对华法林的吸收利用 避免以下草药补充剂 : Ì 苜蓿 Ì 山金车 Ì 覆盆子 Ì 假叶树 Ì 猫爪草 Ì 辅酶 Q10 Ì 当归 Ì 紫锥花

patienteducation.osumc.edu 5 Feverfew Forskolin Garlic Ginger Ginkgo biloba Ginseng Goldenseal Horse chestnut Inositol hexaphosphate Licorice Meililot (sweet clover) Pau d arco Red clover St. John s wort Sweet woodruff Turmeric Willow bark Wheat grass Use of herbs in cooking, such as garlic and ginger, are safe to eat while you are on warfarin. Some vitamin and mineral supplements in large doses can affect your body s response to warfarin, such as taking more than 800 units of vitamin E a day. It is safe to take an adult multivitamin each day that contains vitamin K, but do not take other supplements that contain vitamin K, such as a Viactiv calcium supplement. Always talk to your doctor before starting, taking, or changing any herbal supplements, herbal teas, or dietary supplements. Ì 野甘菊 Ì 毛喉素 Ì 蒜 Ì 姜 Ì 银杏 Ì 人参 Ì 金印草 Ì 马栗 Ì 肌醇六磷酸酯 Ì 欧亚甘草 Ì 草木樨 ( 甜三叶草 ) Ì 保哥果 Ì 红三叶草 Ì 圣约翰草 Ì 香车叶草 Ì 姜黄 Ì 柳皮 Ì 冰草 服用华法林期间, 烹饪时使用的草药 ( 如蒜和姜 ) 可安全食用 某些大剂量的维生素和矿物质补充剂可影响人体对华法林的反应, 如每天服用超过 800 单位维生素 E 每天服用含有维生素 K 的成人多维生素剂是安全的, 但不要服用其他含有维生素 K 的补充剂, 如 Viactiv 钙补充剂 开始服用或更换任何草药补充剂 花草茶或膳食补充剂前, 务必咨询医生

6 patienteducation.osumc.edu Liquid nutritional supplements Liquid nutritional drinks like Ensure, Boost, and Glucerna have a low amount of vitamin K added to 8-ounce bottles. If you drink several of these bottles each day, your vitamin K level may increase and require your warfarin dose to be changed. If you use these nutritional drinks, tell your doctor that you are taking them since it may affect your warfarin dose. 液态营养补充剂 8 盎司瓶装的液态营养饮料 ( 如 Ensure Boost 和 Glucerna) 含有少量维生素 K 如果您每天饮用多瓶, 您的维生素 K 水平可能升高, 并需要改变华法林剂量 如果您饮用此类营养饮料, 请告知医生, 因为这可能影响您的华法林剂量 Medicines Some medicines can affect how warfarin works. Ask your doctor or pharmacist before you start or stop any medicine, especially the following: Another anticoagulant (blood thinner) medicine Medicines to treat depression or anxiety Antibiotics NSAID pain or arthritis medicines - check labels of over the counter medicines to find out if they contain a NSAID Steroid medicine 药物 某些药物可影响华法林的疗效 开始或停止使用任何药物前, 请咨询医生或药剂师, 尤其是以下药物 : 其他抗凝血剂 ( 血液稀释剂 ) 治疗抑郁或焦虑的药物 抗生素 治疗疼痛或关节炎的非甾体抗炎药 - 查看非处方药标签, 了解其是否含有非甾体抗炎药成分 甾体药物 Talk to your doctor or health care team if you have any questions about your care. For more health information, contact the Library for Health Information at 614-293-3707 or e-mail health-info@osu.edu. November 15, 2017, The Ohio State University Wexner Medical Center.